Time for my yearly check in! And what an odd time it's been. Seriously. 2020.... well, ugh. First, the good news: all is well on the jaw front still! Everything is stable and in it's homes still. Dr. Karas is still keeping an eye on me for joint issues and says for now everything looks pretty good. I have had some stiffness since a longer surgery under general anesthesia about a month ago (more on that below and an explanation about why I have been so absent from my blog and any contact submissions), so I may do a few PT appointments to get full range of motion and flexibility back. Sadly this is just the stuff you have to deal with after a bunch of jaw work.

So, that was the good. The rest of 2020 has obviously not come without issue. The world is upside down in a pandemic, and I was also diagnosed with thyroid cancer this past December. It's been a whirlwind the last 6 months with all of that-- both the pandemic, and then having cancer in the pandemic. I have been having issues the last few years with generally not feeling well. Super low energy, major depression and anxiety, and lots of other issues like weight gain, severe hair loss, skin changes, etc. I knew I had a tumor that was in my thyroid, but specialists assured me 95% of these things end up being benign, but they wanted an ultrasound once a year to monitor. Well, this year it grew in size and looked to be expanding into the thyroid wall and then other parts of my neck showed possible metastasis. After a little mis-diagnosis on the extent of the neck and lymph node invasion, and several work ups with major medical institutions here in the Bay Area, we finally got a consensus that there was no neck invasion. Phew. So, countless scans, blood work, different kinds of biopsies, genetic testing, and a ton of time in various hospitals and doctors offices all over the Bay Area, and learned that, yes, I have cancer, but we got it early and I was in a very very good position and a good candidate to just have half of my thyroid taken out for now, and then we'll just closely monitor the other half and surrounding neck and lymph nodes. I know some people think that sounds crazy, but for thyroid cancer this is doable. It's the slowest growing cancer you can get. I do have two masses on the right side of the thyroid, but all of the specialists I have seen at UCSF, John Muir, and Stanford all agree they appear to be benign cysts on ultrasounds. So, I get to have blood work every 6 - 12 weeks for the next few years and ultrasounds every 6 months. If anything looks wonky, then we start all over again and biopsy with a full work up, and they'll go in and take the rest of my thyroid out and any involved neck tissue or lymph nodes. I lucked out and don't need radiation right now, but if there is a recurrence, then there will be radiation for sure. I'll take what I can get right now, and feel very lucky to be basically in as good shape as I can for this kind of cancer. Now I just need to figure out meds and thyroid levels. I have been feeling pretty up and down the last month. Some days I feel OK, and other days it's just exhausting to lift my head up and use my arms. Hopefully this too shall pass.

Why the long update on mostly unrelated jaw stuff? Well, I want to let you know why I have been out of touch. The last year and even two years have been pretty rough on me. I took some time to step back from jaw groups (not all the way back, but more of a passive role for sure), have done less outreach and advocate work, and I have taken time to take care of myself and spend time with my husband and see my family more. If you have reached out to me through this website and I never responded, I am incredibly sorry. I am usually REALLY great with messaging,  but especially over the last year, I have let messages and personal emails drop off big time. Some of that was because of the depression and anxiety I was struggling with, and some because I have been running around like a chicken with my head cut off working a ton of hours in a full time high stress environment (I'm back in meteorology work in the public safety area again!), leading a project that is getting state and national attention, and dealing with never ending ongoing health issues, including the recent cancer diagnosis. It's just been a lot, and some things had to give. That was one of them. If you didn't get a reply back from me, I am terribly sorry. I keep looking at my emails and thinking I need to go back through the web forms and reply to all of you, but it's going to be tough to do at this point.

Anyway, here's to 4 years post op revision where I am still in pretty damn decent shape. My jaw is still stiff from the thyroid surgery last month, but otherwise just the normal aches and pains still, EG: right disc still pops and goes out for a second here and there, and I am still needing to wear a splint during times of high stress when I clench and make my joints sore. My front teeth are still hanging in there (actually, just had a cleaning this morning and all checked out), and the implant is still doing well too. For those of you interested in seeing Dr. Karas, I want to update that he is no longer in network with any medical insurance. So, check your out-of-network benefits if you would like to visit him. 

Good luck to everybody in or considering jaw surgery treatment! Stay well in this crazy world! 

Man... it's been so long since I have posted a website update that I forgot how to do it! That is the thing with jaw surgery. Eventually you get on with your life more and/or have bigger fish to fry. In my life it's been kind of both since the last update.

I saw Dr. Karas for a 3 year follow up, which ended up being almost 3.5 years post op for me. Time seriously freaking flies! It was weird seeing Dr. Karas in what I felt like was the first time in forever. The last time I caught up with him was back in Aug 2018 when I had pain on my lower left (suspected infection, but a friend poked in to me with their hand hard enough it just pissed everything off around the hardware and osteotomy site there).  As usual, Dr. Karas was all smiles. He's still impressed with how solid my front teeth feel despite how awful they look on xray (they're loose, but not as loose as you'd think seeing how bad the roots are on film), and said my bite looks fantastic still. For the most part I still have zero dental and skeletal relapse (wear your retainers, people! It really matters!!) Thumbs up from the surgeon is always great feeling! I'll see him around the same time next year for my 4 year follow up.

How have things felt otherwise? Pretty much the same as last year, I think. My muscles in my face have never calmed down. I think it's partially because of my stress/anxiety, and partially because my muscles are stubborn and they refuse to ever settle calmly around the new bone positions. I feel like my face is always fighting itself. It's hard to describe. Anyway, my loose teeth are still hanging on. My veneers still look great. I'm wearing a night time splint for my clenching, and thanks to said clenching, I am now getting a day time splint as well. Hopefully that will relieve some of this muscle tension in my face. My TMJ's get stiff and slightly sore in the worst of it, and sometimes have popping that is not associated with any severe pain or locking (woohoo!). I just came back from a dive trip where I still had issues opening my mouth (pain and stiffness) after the first day of diving 2 tanks. This is to be expected and totally normal after all the work I went through. Sucks, but it's a cost of doing business. I'm sure warm moist heat would help me in these situations, but I just don't go out of my way to do it anymore. 

Things are still stable and good overall, and I am still very much enjoying my new (now getting not so new lol) smile. I didn't have any records taken at this visit, so I don't have any of those pictures to update with. And my xray pretty much looks the same as last years, so I am going to leave that out as well. A few pics to show where things are at 3.5 years. I'm still not in love with my new nose, but again, it's the cost of doing business to get my bite right. 

Admin note for website inquiries-- I am sorry if I have not gotten back to some people recently. I am incredibly bogged down with work and typically on my work machine, which does not allow my personal email to be opened. I have totally sucked at checking emails the last few months with work being crazy. I WILL eventually get back to you guys....eventually, I swear. :)   

Life works in really weird ways sometimes. I had a 2 year follow up scheduled with my jaw surgeon on May 10 (even though my surgery anniversary is in Feb-- my follow ups got pushed back since I had plates/screws out last Feb and we wanted to do my follow up and records after that swelling had gone down). It had been on the books since my follow up last year. Every 4 months I get a card in the mail from my ortho to call and book a check in with them, so I got that card last week and they were luckily able to squeeze me in right ahead of my surgeon follow up, killing two birds with one stone for my 45 minute drive up to their offices in the same area. Sweet!

So, I sit in my ortho's chair, and as always, he's all smiles. Seriously, I love the vibe off of him when he gets to look at where we are with all of this. I'm glad he's proud of his work. He very much should be. As usual, my teeth are perfect. Zero relapse. Zero changes. By the ortho powers that be I have gotten lucky for once and my retention phase has really gone well with no shoes that have dropped. He decides to release me from treatment. I don't think my brain registered what that meant, because on the way out I just gave a normal, "Thanks! See ya next time!" and then when I got in my car driving off I realized..... there might not be a next time if all goes well. I should have given him a giant hug and told him thanks a million again. I was tempted to stop by after my jaw follow up to do that, but I didn't want to be creepy so I just sent him an email telling him I kind of had a brain fart on the way out and it didn't really hit me that it was for real good bye this time and sorry if I came off kind of distant when it was a legit, 'bye I may never see you again,' type of bye. I think he understands. And honestly, knowing my teeth, it probably won't be a forever goodbye... just until next time. And as much as I love seeing my super amazing team, it's always good to NOT have to see them, so lets hope I can get a break for a while there. 

I see Dr. Karas right after for my 2 year follow up. All smiles from him as well. Everything looks amazing. We chatted about my right disc that has been slipping a little the last few months, and like I thought, it's really nothing out of the ordinary for an issue I may experience after surgery. I knew that, but did want to let him know what was going on in case he thought anything different. Like the rest of my subluxing and dislocating joints, I just need to learn to do things to avoid pissing the joint off, and knowing when it's time to back off and give it a rest, and how to strengthen and treat it well. No biggie. Overall though he's super happy, and especially happy with how far I can open. Typically patients do not get the opening back that I have after what I have gone through, so I'll definitely take this win here! Otherwise everything else is great too. Hardware looks good on latest xray, and osteotomies still looking well healed. It's always nice to go in and get great news from my docs when I am so used to hearing not so great news. 

Toughest part for me will be to stop this clenching I have been going hard at the last few months, which is probably a huge reason that disc is not happy. I've been under a lot of stress with work and with life in general (recently had knee surgery, and every surgery is so anxiety provoking for me given what happened in my first jaw surgery), and I have been clenching like a mofo lately. Hopefully life calms down and I can take a deep breath to let those muscles relax. In the mean time, both my ortho and surgeon have suggested a custom guard again, which I will ask for at my cleaning next week with my prosthodontist (I see the trio for check ups this week-- a rare treat in retention phase lol). I also got a chance to ask how my condyles look. I am always on my toes for changes there since 1.) it happens as you age and increases risk with each jaw surgery and joint remodeling from that. 2.) it happens more to women. 3.) I'm higher risk because of my connective tissue issues with the Ehlers. But great news here too-- I have had no changes since the remodeling from surgery. My condyles are big, healthy, strong, and happy in their homes. My MRI report pre revision did mention some flattening to the heads of the joints, but again, these are all changes that are par for the course with jaw work. And honestly probably happens with natural aging too. But, this news made me VERY happy. I'm crossing my fingers this continues for a super stable happy class I long term occlusion.

The reason I opened this post up with "life works in weird ways," is because when I got home from both check ups, I got a Facebook memory from 5 years ago. The day I got my braces on for the first time with my first team. What are the chances that I would get released from treatment exactly five years to the day?! I was already feeling kind of emotional to be truly closing part of the chapter on all of this, and then when I realized it happened exactly five years to the day on the dot from when I was first banded.... it was just weird. Meant to be I guess. It's been a long road:

May 2013: First banding with first orthodontist.

April 2014: First jaw surgery with first surgeon.

August 2014: Switched to a new orthodontist and jaw surgeon for retreatment.

December 2014: Braces come off for a month to reset for retreatment.

January 2015: Lower incisor extracted. Braces go back on for revision.

February 2016: Revision jaw surgery.

August 2016: Debanded.

May 2018: Final ortho check and released from treatment. I will continue to follow up with my jaw surgeon yearly.

It's not an easy process. A lot of the last 5 years has been hell for me, and I am kind of a different person now after going through all of this. Some changes are for the better, and some not so much. I do still feel like I lost a part of myself going through the trauma and abandonment in the first treatment. I'll never be the same after that, even with all of the therapy I am going through to talk about it and despite the more than successful retreatment. I feel like I am still left being a little bit of a bitter person now. My revision team would tell you I have a great attitude, and overall I do, but compared to how I used to be, I am definitely more depressed and bitter. I've lost that child like optimism and instant trust, like when you didn't know any better as a kid. Now I trust no one, especially when it comes to medical providers. I have had SO much anxiety over this recent knee surgery. Any doctor who handles me now is going to have his hands full of somebody who 1.) is a little too much science geeky and asks too many questions to understand EVERY little thing happening with their treatment, and 2.) is full of skepticism and distrust. Always waiting for the other shoe to drop. Maybe things will get better with time, but there is probably a likely chance this is a life long thing for me now, which sucks because with my EDS issues, I see a LOT of doctors.

For patients reading the blog and needing revision-- it's tough. It's one of the toughest things I've ever gone through. But it was worth it to get fixed.  For me especially since my issues were so impactful in the functional aspect and I was in so much pain after my first surgery. Know that you're not crazy. You're not alone. And if you're in a state where you feel crazy because your team is telling you nothing is wrong, then be an advocate for yourself! Get your records, start going on other appointments. I've had several patients recently (and one from my infamous first surgeon!) go through exactly this, and learned on their consults that they were right-- things weren't correct and need to be addressed. I just can not fathom how a surgeon and/or ortho looks a patient in the face and tells them everything is great and results are perfect, when it's very obvious they aren't. This was the deal in my case too. It was laughable how obvious my results were, and I have no clue how they thought they were going to get away with spinning it any other way. My first surgeon probably knew this, and it's why she choose to just not talk to me or see me instead of trying to explain something away that couldn't be explained away. And she knew I was too smart and knew better right away. She was screwed, so she ran. I don't know how people like this sleep at night. If your gut is telling you something isn't right, then pick up and go get some other opinions. Sometimes we have to be our own advocate, and it's not easy. That is why I make myself available off of my website. I'll help the best I know how through my own experiences.

Anywho...this has become a long post. Here are some recent shots to show where we're at. The one shot is the Facebook memory I had pop up to tell me it was 5 years ago to the day that I got banded. That is a pic from that day. I kind of miss that face in a lot of ways, but I am SO happy to have normal looking teeth and bite now!

**I got a new pano from my surgeon the other day. It will be loaded once they send it to me**

I know I say this a lot in my posts, but hot damn does time fly. Two years post op from revision. April will be 4 years post op from my first surgery. So...where are we at for the two year mark?

Function: This has gone so much better than I thought it would. I think it's gone better than my providers have anticipated too. I just followed up with my orthodontist about 6 weeks ago and he just looked happy as a pig in slop and can't believe how perfect my bite is still. So much so that he even talked about releasing me from check ups (so long as I promise to check in with him if I have the slightest hunch something is going off the rails). Dr. Karas is feeling good about everything too, making similar comments on how solid the bite is still. ZERO relapse, which is crazy good news! Pretty much zero skeletal or dental relapse from what I understand. My front teeth are still hanging on for dear life. Tooth 7 is still the most noticeably loose and heeby jeeby feeling, but by the grace of the tooth powers that be, it's still hanging in there and not any loser than it was after it firmed up again after ortho, which is super great news. I am chewing on both sides of my mouth for the first time in half of my life. It feels odd still, but I'm slowly getting used to it. I'm still on the #SnoreNoMore team. My snoring/apnea is gone thanks to my rotation and jaw advancement. 

Are there a few lingering issues on the function side? For sure. Obvious first one is the ticking clock left on these front teeth. So far so good, but who really knows how long I have left on them. My jaw still tires. Not as quick as it did the first few months from surgery, but for sure noticeable. If I eat gummy bears I definitely can only take so much before my jaw fatigues. My opening is slightly more limited than it was originally. And again, if open too long or clenched too long, I get fatigued/sore. I have a super weird rattle up in the upper sinus area between my actual sinus cavity and top of my pallet. Doesn't happen all the time, but when it does it's REALLY odd feeling. I had never had it until after my plates/screws were removed. It was bad immediately after that surgery and took a few months to wane to what it is now. I am wondering if that is more nerve damage causing a weird or phantom feeling than something really physically rattling up in my sinus cavity. My upper scar tissue is not perfect. My right side was slightly improved after scar revision, but we ended up missing a section on my left that bothered me AND kind of making the parts of the incision that we did get a little lumpier and worse off. One other thing I noticed recently is I do have a slight lisp still. This necessarily isn't related to any of the whacky stuff that happened to me and just could be purely the new position of my teeth/jaws I am not used to. I might benefit from speech therapy, but I don't think the lisp is bad enough to really address in that sense. My numbness is the same as it was by the 6-8 months post op mark: my right half of my lower lip/chin is pretty numb (yet oddly oversensitive too. if I brush against my chin or lip it sends mild shocks/tingles through my lower face), and same with the gums on that side. It's hit or miss patchy paresthesia. And then very recently I have noticed my right TMJ feeling funny. Both TMJ's out of nowhere are feeling tight, and I am getting the feeling like that right disc wants to slip again. I even had it lock a bit recently for the first time ever. Freaks me out, but I am hoping it's all just normal part of life now and I need to listen to my body and give my jaw a break when this happens. I'll talk with Dr. Karas about it when I see him for the 2 year check up in May.

I don't expect any of these things to be perfect. A lot of this is par for the course and the price to pay to have jaw surgeries like I had. And some of this can be attributed to the damage from my first surgery and the need for the second. Actually, most of what I have issues with are exactly because of that. And it is what it is there. Not the end of the world for sure. 

Aesthetic: I feel like now 2 years out that I have settled enough and had enough time to come to a final conclusion about how I feel on all of this. I would say around 1-1.5 years post op I finally stopped waking up to feel surprised or feel like my face was foreign when I looked in the mirror. It finally became my new normal. I am definitely more confident in my smile now. I think cosmetically my favorite change is having the gummy smile gone. I still find myself posturing my lower jaw forward at times or not smiling all the way at times (to hide all the excess gum I used to have), but for the most part I have stopped. Again, this has finally become my new normal. 

That being said, now I can say what I am not a fan of, and it's actually things that bothered me right off the bat. My nose is still REALLY wide for me. If I were to go back and do a correction with a cosmetic procedure, it would be for my nose. Unfortunately I get a lot of surgery because of my joint issues, so I have a hard time forcing myself in to a surgery that isn't for functional limitations and is purely cosmetic. I also feel like skeletally I am still slightly class II, especially when my mouth is kind of relaxed hanging open or partially open and my lower jaw is not all the way autorotated up/closed. And part of me feels like this has gotten worse in the last year, so maybe that is some kind of muscle relapse or something. Who knows. I am also not a huge fan of my general face shape right now. I feel like the CCW rotation and lower jaw advancement gave me more of a square/masculine look, and overall I feel like this has all aged me a little. Who knows, maybe I am just in a time of my life where I would have noticeably aged anyway. Because of the lopsided twist I was left with after my first surgery, that has caused a slightly noticeable bulge on my left side vs. my right, and it's caused a dimple on my left side vs. no dimple on my right still. This for sure is not high on my list of "what bugs me the most," but it's worth mentioning. I hate to say this, but outside of my gummy smile, I prefer to have all of the old features of my pre-surgery face. I am kind of OK if this was the price to pay to get my teeth in better shape though. I'm chewing better, things are keeping cleaner MUCH easier, no cavities or other whacky issues like I used to be plagued with, my sleep apnea is gone, and my bite is class I. I am thankful for all of that, and if dismay over my post p nose is what I have to live with for it, then so be it. 

One last note that is related to this surgery, but kind of not at the same time-- my hair never really recovered from all of this. I lost a lot of hair after both surgeries. I cut to a pixie cut after revision to let it all reset and grow back out, but I am still REALLY thin up front around my crown/face area. I have noticeable bald spots when I put my hair up. Bummer, but not much I can do. I take a TON of supplements and do all the right things..... but I feel like this is what it is here.

So.... what are the plans from here? I see Dr. Karas in May for a check up. I am not 100% sure what he'll do with me after that. Normally he would have released patients by now, but I am glad he's keeping tabs on me with all the issues and relapse risk to watch out for. He might go in and do some steroid shots on the left side of my scar tissue that is still kind of "meh," but I am inclined to leave it all be at this point. My orthodontist will check in on me around the same time. I think if all looks well at this appointment he is going to officially release me and I just need to call for an appointment if I need something or think something is off and want him to take a look. I still see my prosthodontist 3 times a year for cleanings. He likes to check on everything, keep tabs on my shrinking roots, make sure everything is tidy and well. When it comes time to finally address those front teeth, he and my surgeon will get together and plan again. Lets hope that doesn't happen for a long time! 

Finish with a recent picture to show where we're at....ps: GO EAGLES! 

I've been a bad blogger.... no updates in a while. Tsk tsk! Life gets in the way sometimes, and boy has it ever lately!

First the teefs. I've been a REALLY bad blogger because I am usually good with posting an update when I get anything with the mouth done, but I didn't do that! D'oh! So, remember when my surgeon said he could work on some of the lumpy scar tissue (from plate removal....as well as the two jaw surgeries before) down the road once it settled? I decided to do it. I was on the fence. It didn't cause me any pain and I wouldn't have considered it stiff. Just a few small pockets that bugged me in terms of touch and I occasionally got food stuck in a few nooks and crannies. Really though, it wasn't a huge deal.....but I did it anyway. I went against my own advice that I give other patients: If it ain't broke, don't fix it. I think I got caught up in a little moment of, "but everything with Dr. Karas has gone so well and if he can make these few bumps better, than why not perfect it?" No....no no no no. If another patient had come up to me in my situation and said, "What do you suggest?" I would have told them leave it be. ::sigh:: and I didn't even take my own advice.

I am not sure if I am feeling this because of my own feelings being projected, but I got the feeling my surgeon was kind of, "Ugh...this patient....still? Ugh." Like the guy is never going to get rid of me. It was the first time I felt like he was kind of over it. He didn't say anything in particular to make me feel that way.... just a vibe I got, and again, I could be wrong and totally projecting my own feelings since I felt like an ass for even asking for the scar revision. If he was feeling that way, I think he's totally right and completely justified. Looking back on this now (and even before I got the scar revision...which is part of the reason why I had hesitancy getting it), I think it was a dumb thing to even ask him to do. It didn't need to be done, and I was grasping for him to needlessly try to perfect something that he already has gotten damn near perfect with in every way given what I showed up on his doorstep like. Seriously, I feel like a real asshole after this one, but I can't go back and undo it. I just hope my surgeon doesn't hate me for being THAT patient on this one.

But anyway, I am digressing here ......anywho....so I get the scar revision on my top jaw mid Sept. Again... wowzers...just like plate removal, did I underestimate the pain! I didn't get dead numb for the procedure itself so I felt more of it than I would have liked. I tried so hard to not complain though. I was pretty much stitched second molar to second molar again. It was about 3-4 days of suck, similar to plate removal. I didn't swell as bad, but definitely had noticeable puff and was even a little black and blue. Stitches fell out within the week again. Go back for a follow up and just my luck, we missed the ONLY section on my left that bothered me. I could tell when the stitches were in that they ended right before the little pocket that bothered me the most. Ugh. Oh well. I am not having my surgeon cut in to this again. Not only because I think it's not worth it at this point, but because I feel like an asshat for having even went for all of this on this one. AND it was WAY expensive. Usually I get an estimate before a procedure but didn't get it for this one. I figured it would be similar to plate removal....NOPE. Plate removal was actually LESS than this. Actually, the co-pay for my actual jaw surgery was less than this! Nuts. Almost $1,800. Yep... not making this up. Whatever my surgeon wants I'll pay it, so I am trying to not sweat it but it's just a lot on top of everything else that has gone down for me the last few months..... and lets transition in to all of that.

Now I am really going to go off topic a bit because a lot of this other stuff doesn't have anything to do with my jaw necessarily for once, but I'm going to lay all this out there so you can truly understand how awful the week of recovery was for this scar revision surgery. I can only think of the phrase, "when it rains, it pours." I have been having neck/back issues for a long time and finally got around to doing an MRI.  Figured it would be smart to schedule it the day after scar revision and use my down time efficiently to avoid taking more time off of work. Not a smart choice to lay yourself down in an MRI machine, where they don't want you to even swallow if you can avoid it, with oozing stitches from surgery the day before. Not smart at all, but I pulled it off. Get the MRI results back and find out I have a disc bulge at my C3-C4, and a complete rupture/herniation as well as a tear in the disc at my C5-C6. If that wasn't bad enough, they also find a 9mm mass on my thyroid. So, now I'm dealing with scar surgery recovery, getting scheduled with a doc to get the thyroid evaluated, and setting up surgeon consults to get opinions on what needs to be done for the obliterated disc in my neck. To add insult to injury, my chiropractor (who kind of has no business trying to interpret my MRI), tells me he thinks I have another mass on my spine that may be responsible for the disc issues. And that just sent me over the edge. I sat in my car and bawled coming out of the appointment with my chiropractor. Luckily I later found out in my first spine surgeon consult that it is NOT a mass on my spine, and the return on the MRI is the tear in the disc that is flopping out of where it normally is and pushing in to the sack around my spinal chord. Phew. Been in PT for the neck and evaluating surgeon opinions. I am willing to tough this out as much as I can and exhaust all the conservative options, but it's a real possibility this is going to end in spinal fusion surgery. Another surgery.... great! Ugh. 

So anyway.... after all of that happened, then it REALLY put the scar revision in to perspective and I apologized to my surgeon and told him I should have never asked him to do the surgery and it was unfair of me to try and perfect something that was already in pretty good shape, all things considered. Hearing you have not one, but two masses in your body (and thankfully that is only one mass now) can really put things in to perspective for you and you realize how insignificant something is. Again, I feel like a real ass for even going for this scar revision. And to add insult to that, overall I feel like not only did this scar revision not make things better..... I feel like it's a little worse off now. Again, I am leaving it be now. This is the bed I made, and I am going to lay in it and quit bugging my surgeon and making more work for him that he doesn't need.

I am not trying to scare people out of scar revision. If your scar is painful for you and/or tight, then by all means get it worked on. If it's just lumpy and bugs you to the touch? Leave it be. That is the cost of doing business when you cut in to all of this delicate tissue.  

I don't know if there is something in the water recently or what, but about a dozen times in the last month or two with different people I've had this conversation about my jaw surgeries and current place in recovery, and I know they mean well, but it's a tough conversation to have.  It's the "but you look great!" conversation.  The "but it was all worth it because you look better now!" conversation.   I wanted to talk about it because I have talked to a few other patients who have run in to the same issues and wanted to put my feelings out there in case anybody else is dealing with it and know you're not alone.  It can be a tough conversation to have, because how do you respond politely?  Bottom line:  No.... for me, it wasn't all worth it for that.  Not at all.  If somebody had sat me down at the beginning of treatment and said, "We can make you prettier, but you'll lose 7 of your front teeth for it,"  I would have NEVER done this.  EVER.  That is not to say I didn't understand the risks.  I understood them and understood the context in which they could happen.  I always tell jaw patients to understand the risks and the probabilities of each risk.  Be OK with the possibility that you can end up as a statistic there.  So, I understood and was more than informed and aware.  And I could have backed out and I didn't.  But I am not mad at myself there.  People would never have surgery at all if they weren't willing to assume any risk at all.  But you understand the risks and then make the best decision for you as the patient.  Hope for the best, but be aware and prepared for the worst if it were to unfortunately come bite you.  

It's a fine line of being thankful for improvements you have gotten from jaw surgery, yet knowing it's OK to not be OK with the costs of those improvements.  For me it cost me my front teeth.  I'm not even talking about the monetary cost of that.  I'm talking about the cost of something so dear and permanent and all of the complications and upkeep I'll have to address for the rest of my life now for it.  I'm going to need multiple rounds of tissue and bone grafts over the years as everything recedes around the implants and spaces where teeth are missing and filled in with a bridge.  I am probably going to need to replace the whole implant supported bridge segment(s) a time or two through my life since I am getting this done at such a young age.  There is a reason why people have nightmares about permanent teeth falling out or being pulled. There is something devastating about losing something so permanent and intimate as a piece of you responsible for so many facets of how we live/function.  How we survive through food!  And to have it be almost all of your front teeth!!  That is absolutely devastating.  You could have told me I was going to look like Vana White or Megan Fox after this jaw surgery and I still would have told you to stick it straight up your ass if the cost was going to be all of my front teeth.  Sounds harsh, but that is the truth.  

So, it's OK to not be completely OK.  If a friend wants to tell you it's worth it because of X, just politely remind them that your risk vs. reward is different than theirs and it's not worth it for you. And this doesn't mean you're not grateful for what you do get to have out of it.  It's just that it's a fine line balancing being grateful for what you got, but at what cost?  No matter what it's OK wherever you are with that.  

On a totally different note and back to the functional aspect in all of this and another reason why revision was worth it.... I can dive again!! I got back from my Bonaire diving trip two weeks ago and it went great. I had a lot of anxiety going in to it. I wasn't sure it was going to work. I took a diving trip 1 year after my first surgery (when I was left all twisted up...which is why things probably hurt me then) and I had to cancel almost all of our dives due to the pain I was in after the first day of two dives. This trip was to celebrate being done with the harder jaw work. It was also a test to see if I could dive again. Part of me was afraid I would be in the same pain I was in in 2015 during the last dive trip, but this one went off really well. I did about a dozen one-hour dives during the week and besides what I consider normal jaw fatigue, I was in really great shape. SO thankful. I sent the below pics to my docs to give them a shout out and say thanks for getting me back in the water! Anywho... I am really glad to be diving normally again. For you divers out there considering jaw surgery, def talk to your surgeon about it. Typically they don't want you to dive for at least a year after surgery so your joints can settle down and remodel in their new homes. You definitely don't want to mess that up!

So I have "final" written as such because it's not really final per se. These restorations are to get me through until they will REALLY see the final restorations with bridge/implant segment down the road...hopefully a more distant road than they're forecasting. And then "1 year post op," because this appointment wasn't really 1 year post op. Because I had my plates/screws removed the week of my 1 year mark, they moved my check up and records appointment to now (15 months post op) because I was bruised and swollen after the plate removal. So, lots going on the last 6 weeks since my last post!

My prosth gave me my temps and we had an appointment about 3 weeks later to do the permanents. The office called right as I was walking out of the door to get to the appointment for the permanents and the assistant called out sick, so my appointment was canceled. Womp wwwoommmmppppp. So that got pushed off another week or two. At first they wanted to see me yesterday, but then it dawned on me that I was leaving for a diving trip out of the country today and there is no way my orthodontist was going to have time to make me a new retainer after getting the veneers. So in a whirlwind week of appointments, my prosth was able to squeeze me in last week, then I went right over and got fitted for new retainers. Then back to pick up retainers a day or two later, then a cleaning with my prosth this week and another check on the veneers, then back to my ortho for another retainer (more on that later in this post), and then I had my 1 year check up with my jaw surgeon this week.  Needless to say, I am tired of driving all over the Bay Area the last week or so, but I am SO glad to have all of this done and my team work with me to get me all finished up before my dive trip. It would have been a disaster going to Bonaire with temps in. I wouldn't have been able to dive, and the whole point of this trip was a celebratory dive trip to mark me being done with jaw work and being able to dive again. That would have sucked!

Anywho.... I get the permanent veneers last week. They're gorgeous. Really gorgeous and I am SO happy with them. I was joking to my prosth that I was really feeling bummed about spending 7500 bucks on something so vain, but he reminded me those teeth were so compromised and the bonding so hacked that there was bacteria, cavities, and everything else going on with those teeth and medically they required restoration. So, that makes me feel a little bit better. Regardless, I actually was glad about these after I got them. They're gorgeous and really perfect my smile. When we were done my prosth gave me a big hug. I could tell he was proud of where we got after the last few years and reminded me that basically I was a tough case but he enjoyed doing this with me and I had a great attitude through everything. I headed over across the Bay to my orthodontists office and everybody gushed about my veneers, basically saying that they see a lot of dental work come through and they know what good work looks like, and mine is REALLY good work. I already knew that....my prosth is amazing, as is the rest of my docs, and he finally got his time to shine here as he was mostly on the bench through majority of my treatment up until recently. So, needless to say I've been smiling ear to ear after these final touches on my teeth has just really been the icing on the cake at the end of a long bake in the oven of a journey!

When my prosth canceled on me I had to reschedule the visits to my ortho to have molds and a new retainer done. They were nice enough to accommodate me as always. They take a look at my old retainer and think it's still in decent enough shape and fits well enough to send it back to the lab to fix up some acrylic on the front wire to protect it from the veneers (it will scratch them and leave black marks). This was Thurs and new retainer couldn't be ready until Tues. I saw the wheels turning in my ortho's head, and I am sure he saw the look of worry on my face when I thought about being without a retainer for 4-5 days. Right away he said, "for a normal patient that would be fine by now, but for you with everything we've been through and all your loose teeth.... not worth it. Let me make a phone call." And he phones his wife (also a local dentist) and has somebody drop my molds off to her to make an essix retainer with that I could pick up the next morning. Amazing and so thoughtful. Freaking love my orthodontist, and his wife was super nice for helping me out too. I hated being in the essix for 5 days. I clench like a banshee in those and causes me jaw fatigue and a huge headache. So I was happy when Tues rolled around and I could get my hawley retainer back. Ortho takes a look, puts it in my mouth, and I can see the wheels turning in his head again. No go. He said he feels like it took a beating going through the heating/curing process again, the arch bar was still too bent out (my prosthodontist bent it out to keep it off my temps after he put them in), and there appeared to be a weak point in the wire he said would eventually break. Again, because of everything I've been through, not worth the chance of handing me off this retainer and having it bust on me while i am out of the country for 10 days. Even if I wasn't going out of the country, he's the kind of doc that wants to do it right, and I really appreciate that. So, new mold and ordered a whole new retainer. I was sweating bullets thinking I'd be stuck with that essix for two weeks until I was back from my trip, but to my great surprise, he was able to do a quick turn around with the lab and get my retainer in today.... just hours before I hop on my red eye to Bonaire. PHEW!!! So thankful for all the hoops they jumped through for me to get this all done this last week AND get it done right instead of half assed! 

My 1 year follow up with my surgeon went great. He got to get a look at the final restorations on the implant he did and see the new veneers too. He said my bite is dead on perfect still and we're officially past the point of bone relapse threat and now we're just watching for condylar resorption threat. I chatted him up about that more and for anybody else who would find the information useful, here is what he said: ICR (the joint resorption I was just talking about) is more common in women, esp if they go through hormonal changes like pregnancy. It's more common in revision cases. My systemic joint issues don't help me out either. Luckily I am probably not on the baby making train in this life time, so at least I've got that going for me in terms of ICR threats. He said my condyles look great though. Nice, big, round, and they appear well centered and happy in their home. So, lets hope that business stays like that! My opening is around 40mm, which is well within normal limits. New pano shows bones have healed nicely, and when he was in getting my plates and screws he got to get a visual on that and said everything not only healed nice, but REALLY nice. Even nicer than some first time surgery patients, let alone a tough revision. All of this is WAY awesome news. Only hang up is my scar tissue is lumpy after screw removal. This isn't news to me. I knew going in to get the plates out that we were probably going to have to battle that. Nothing my surgeon can do about it. When you slice and dice in to tissue this many times, this is what happens. So, he can go in and free that up if it bothers me more down the road. I do get a little food stuck up in the pockets between some of the scars, but I am waiting to see how much more settles. I want to say it took a good 9-12 months after my surgeries for the scar tissue to fully settle. No big deal to have him free a little of that up real quick at an appointment. All in all though, everything is looking really great and I left the office is really great spirits. And I left the office feeling really odd, because I don't have an appointment on the books now until May 2018. Crazy! 

This was a lengthy update, but a lot going on the last few weeks. Bringing this to a close because I am literally about to walk out of the door to go catch a flight for my first big post op dive trip. My husband has talked about doing this with me as a celebration when I was done all of this mess, and now it's here! We're flying first class and everything, so this will be a real treat. I am crossing my fingers that the jaw gods will be good to me and I have little to no soreness and I can dive as usual. Last time I tried to dive a year post op from first surgery it was a disaster. I had to cancel a few days of dives because I could barely open my mouth after the first day of two tank dives. I really hope that doesn't happen again, but it very well might and I am walking in to this one eyes wide open, but hoping for the best. Here are a few shots from recently as well as the new records from my check up. So weird seeing the pano without the plates/screws around my nose! 

It's here!  The almost final step in my treatment plan!  I say almost because it's actually not the final restorations.  I'd love for it to be, but we know the final restorations will be the implant/bridge segment we have to do later when these teeth finally do start presenting as loose as they should given how awful they look on scans.  We'll cross that bridge when we get to it in the probably not super distant future.  But for the mean time (however long that time ends up being-- who knows!), I am doing veneers on the front teeth.  I always knew this was going to be a part of my treatment plan. I trashed these front teeth a few times over the years, and then my first ortho trashed them even more.  So, I knew this was coming, but now I have mixed emotions over it.  Over the years I had these teeth ground down and bonded to cover up an overlap I had on the front teeth, and old fillings that stuck out in my two front incisors, and in general just a bad patchwork bonding job was done on them more than once.  I wish I could rewind time and yell at my 24 year old self that let my family dentist grind my teeth down and put cheap bonding over them, but I can't change what I did.  I wish I would have just waited to get my teeth fixed properly with ortho and all, but the damage is done, and now I am paying to fix it.  Again, I knew this was coming, but what makes it a tough expense now is I have been faced with the situation of knowing this is a temporary fix that will lead me to an even more expensive final restoration with the implant/bridge segment.  So this $7200 (yes....that is what these 4 veneers cost me yesterday.  Ugh.) is to make my teeth pretty for possibly as little as just a couple years.  We hope for the best and maybe this will end up being a 10 year thing for me before I have to start implant work, but my docs aren't super optimistic.  

So, mixed emotions spending this much money on something that is 1.) So vain and superficial, and 2.) temporary in the grand scheme of things.  And now I am doing this after I just took a new job and got hit with an almost 50% pay cut.  Super ouch!  BUT..... I owe this to myself after everything I've been through to get to this point.  Could you see that patchwork bonding in pics and from far away?  No.  Could I see it?  Could my dental professionals see it?  Could my husband see it and friends up close see it?  Yes.  For sure.  Plus the bonding kept chipping off, turning different colors and getting worse, and the places where it was little slivers/chips, I was shredding floss on like a mo-fo.  So, there was some functional issues here too.  I am looking forward to not shredding floss anymore (and having an easier time flossing with smooth lateral tooth surfaces), and I am looking forward to having properly sized teeth.  One of the issues through treatment is my first ortho adjusted the size of my teeth and screwed them all up.  So both of my incisors were different sizes, both laterals were different sizes.  It looked goofy.  I am glad to get these guys the right size/shape finally. And I am glad to not have to look at my first ortho's hack job anymore.  It was a constant reminder every day looking at what he did to me.  I don't deserve to be reminded of that every day.  So, hopefully this will help me move on there.

My prosth asked me if I was at all surprised about how things went yesterday-- the whole process of prepping these teeth and getting my temp veneers on.  I told him I wasn't.  It wasn't that far off from other work I've had done, esp the bonding on those teeth.  It was very similar in a sense where they prepped the surface of the teeth (although didn't take off nearly as much natural tooth surface), wrap the cords and stuff around the teeth to push the gums up, cure things, etc.  I was in the chair for about 3 hours.  Worst part of the whole thing was the needle to get numbed up.  Needles up top/front are always more ouchie, but he stuck me right in fresh scar tissue from my plate removal, and that was SUPER ouchy.  Like, I had a few tears sneak out from the corner of my eyes and Dr. Lew totally caught me and handed me a tissue.  I hate being a baby, but I wasn't expecting this ouchie at all.  Normally it's no big thing taking the novicane shot, but damn this one was one of the worst ones I've ever had.  The rest of it was just discomfort in my back from laying down in the chair so long, and then my jaw joints from being cranked open for 3 hours.  A few good tidbits during all the work in this appointment:  1.) No decay.  I think my prosth was ready to find some decay under all the old bonding and fillings in my front teeth and he said they looked great.  2.) Both my prosth and the chair side assistant gushed over how amazing my gum tissue is.  Like, multiple times remarked about it.  This makes me VERY happy.  I've worked hard to get to a place where I take really great care of myself now.  I started this journey with severe periodentisis with 5-8mm pockets around teeth.  It feels really good to be in a place now where I get compliments along the lines of "these are some of the best gums we see in here!"  And on the same token Dr. Lew quipped that even my retainer is kept so clean, like it basically looked brand new.  Yep, I work hard on that too, so I'll take it :)

So, 3 hours and $7,200 later, I have temps in and my actual veneers are on order with a lab and I'll go back April 18th to hopefully get them seated for good.  If they are not perfect and to Dr. Lew's high standards (which I am thankful for!), he'll send them back and get them right before he permanently cements them.   Dr. Lew was also able to adjust my retainer for me in his lab, so it fits the temps he put on and he saved me an hour trip over to see my ortho to do that.  Super awesome of him!  Speaking of Dr. Lew, he also mentioned to me that the CA Dental Board did contact them to initiate their records request for my case, so it sounds like the dental board is moving forward with an investigation, which is great news.  From what I gather, they typically won't even take this step to get records and start investigating if they don't think there is something there worth looking at.  They'll totally close a case before it even began in that sense.  So, this is really great news.  I think I am finally feeling better pushing forward with this.  The few bits I have gotten to talk with my team about have been pleasant.  They have given me as warm a response as I think I can get here, so I am moving forward with the belief that they are on my side and they don't think I am a bad person for doing this.  I really hope not, because this dental board investigation train has now left the station and it's out of my hands.

Here are a few shots I had fun doing fb updates with in the chair yesterday.  I have no shame.  :)

I decided to make a blog post about this issue because recently I've chatted with a few patients who are having issues with this:  Records.  They're yours.  All yours.  ALL of them.   YOURS.  Each state varies in terms of the circumstances around timing of when records are to be given to you  upon request, but by law they have to be given to you.  Your doctor(s) can not hold them hostage for whatever reason.  More than one time now I've caught an orthodontist saying something like, "We can't release records until final payment," or, "We will only release them if you sign a document releasing all liability for us and gagging you from talking about your care with us from this moment forward."  You do not have to sign anything except for a records release form.  You can even put one together yourself here from the American Association of Orthodontics.  This is the only form  you legally need if they ask you to sign anything.  If you get something that looks like it's speaking legal-ise and demands anything from you in exchange for the records, then run for the hills.  

So what happens if you're in this situation?  I can speak from my personal experience and the experience of a few patients I've helped.  I had put in a verbal request for records with my orthodontist a month or two before leaving his office. I never was able to get my full records, and for various reasons, I really wanted them.  I also wanted my new orthodontist to have them in case there was anything to help give them an idea of where things were and then plan my new treatment from there.  I told my new ortho that I was having trouble obtaining my full records.  They filled out this AAO form, faxed it to my old ortho, and then I was eventually able to get "full" records.  I say "full" records because it wasn't full at all.  A lot was missing (like, anything regarding my surgical planning, notes, times/dates of when my ortho/surgeon talked, etc, etc) and I was told they just don't keep things like that.  And in case anybody reading this is wondering, yes, that is illegal too.  Doctors follow a certain medical care standard of what is kept and what isn't kept, and almost everything gets kept.  Some things are required to be kept longer than others, but most things get kept. Especially important treatment notes on a major surgery and said planning and discussion for it.  I kept the AAO form, the date/time I faxed it, the date/time I got my records finally in my hands.  This has become especially useful now, 2.5 years later, when the CA Dental Board is investigating my first set of doctors and they can possibly see fines and dings on their records for not meeting the standard of care set forth when it comes to dealing with records.  

I was fortunate that my orthodontist did not try to hold my records hostage from me in exchange for anything.  Instead they just held them for me for.... I don't know what... but at least I finally got what I could.  At the time I was consulting with a lawyer about everything, and he was the one to give me a heads up that more than likely my ortho was going to try to slip in a note releasing all liability in exchange for my records and I was to not sign it.  Luckily I didn't run in to that at all, which looking back on it now, is VERY surprising.  Not only that, but my ortho called me within minutes of them getting an official transfer notice from my new ortho and they offered up a full 100% refund of my $8300 treatment cost with their office.  Again, I got incredibly lucky there.  

So, do not let your doctor bully you.  Your records are legally yours.  They HAVE to give them to you.  If you feel like you are being done over on your records, look up information for your states licensing board and file a complaint with them.  More than likely it's illegal.  In CA you have X days to give a patient their records after request.  If a complaint is filed and it's found you were past the timely date of records release, you can be fined X dollars per day for every day you were late.  Don't let them get away with it.  A good doctor will have no reason to want to cover their tracks and hold your records.  Do NOT be gagged!!  Do not sign anything that will release liability and gag you from talking.  That is bullshit.  Don't let it happen.  Look out for numero uno here.  Don't worry about hurting the feelings of the nice lady working at the front desk in the office if you have to call and talk to her about this.  She understands.  It's just business.  Stay polite, yet be firm.  Like everything else in this process, sometimes we need to be advocates for ourselves.  Unfortunately this is one of those instances.  Keep good notes on everything.  Dates/times of your requests and copies of all exchanges and faxes.  It may help you later down the line.  Keeping detailed notes and keeping good records has for sure  helped me in more ways than one through this journey! 

Progress.... but totally not in the way you think!  Yes, making good progress on the medical side, but this is progress on the justice side (or as much justice as I can get from all of this).  I mentioned in an earlier blog post that I finally put a formal complaint in against my original surgeon and orthodontist with the Dental Board of California.  I tried to get my story in a nice little summary for them and submitted it back in late 2016.  I knew it could take a while for them to process the paperwork and notify me of an investigation, but I've heard nothing in the last 5 months.  I was honestly starting to get concerned. I have read tid bits that said the dental board won't investigate a complaint over two years old.  At the time I put mine in it was just over 2.5 years old.  Why did I wait so long to finally put this in?  Multiple reasons.  First and foremost I wanted to take care of me medically.  That was exhausting and overwhelming enough.  And at first I was actually talking to a lawyer and was going to go full on legal with all of this.  That too was exhausting and overwhelming.  I just thought this was going to be one more thing to battle in the middle of everything else and I wanted to wait.  Turns out that the process wasn't that bad (so far at least), so in hindsight I should have done it earlier.  Anyway, I was afraid they would tell me my complaint was too old, but I got a letter today saying a case is open and they requested more information from me:

I actually already sent them this information with my original complaint, but I didn't waste any time putting it all together and sending it again today.  I looked at the list of doctors after it was done and it just blows my mind.  I bounced around between a dozen docs all over CA (some of which I drove 6 hours each way for) on the path to fix me.  All of them will have to have records released to the dental board about my case, and more than likely I bet they might actually interview and chat with my current team.  I talked in the previous blog post about how I spoke with my surgeon about that.  How unsettled that left me.  Time has helped me get over that a little and things are totally kosher between us,  but it still sits in the back of my mind.  And now getting this letter from the dental board just brings up all the anxiety again and I am left wondering if any of my doctors think I am wrong or a bad person for going after my first surgeon and ortho like this.  I'm not suing them or anything, but this is still going after them the best I can otherwise.  And then it leaves me thinking, "What will they tell the investigator if they have to talk to them?"  Who knows.  I am not asking them to do me a solid and speak to the level of care I got in my first treatment with these guys, but I hope them explaining  my records and answering questions offers enough information where it all just speaks for itself.  

I am cautiously optimistic that this is the direction this will go.  I mean, there are many things that were wrong in my first round of treatment, but some of them were blatantly illegal/negligent, IE: my surgeon totally abandoning me.  Pretty sure that is illegal.  You are not allowed to abandon a patient like that.  And my ortho taking forever to get me my records and giving me a hell of a time with that.  And then both my surgeon AND ortho were missing or "lost" all of my records pertaining to my surgical planning and anything pre op having to do with my surgery.  Nothing.  Whether that was done on purpose (and come on.... what am I supposed to think here?  How convenient is it that both of them "lost" all records pertaining to most of what was in question in terms of the level of care and negligence factor in all of this?)  or it truly was a mistake that everything in my records relating to my surgery or any notes,  discussions, plans, etc were gone, either way it's illegal and they can be dinged for that.  EVERYTHING is to be charted during treatment.  Even looking at my charting when I am sitting in my current ortho's chair I see a ton on the screen for me.  If my ortho so much as called my surgeon and spoke to him for 30 seconds, that call was annotated in my records.  If they email, then that email is saved.  If they got together and talked, then those notes were saved and discussion date/time annotated.  Nothing was kept from my first treatment.  When I questioned why there wasn't even so much as a mention of an email back and forth between my surgeon and ortho talking about even the simplest of things, my ortho's office told me, "We don't keep those kinds of things."  Hopefully they will be dinged for that because you ARE supposed to keep those kinds of things.  And I have a feeling they do keep those kinds of things for their patients.... but it was conveniently lost for me because they knew they screwed up and it was going to come and bite them.  

Anyway, this is the only form of justice I will ever have with this.  My last chance.  I will never get a chance to look my surgeon in the face and get answers for what she did to me (or what she allowed her resident to do to me unsupervised or ill supervised), let alone get an apology....which doesn't even matter to me honestly; I'd rather have everything explained to me instead and have the answers for what happened.  The best I can hope for here is that the board that holds her license will find that she really did do me dirty and she'll have some consequences to face.  Same with my first ortho.  If anything, hopefully I am doing a service so something may come of this and help a future patient avoid what I had to go through.  Maybe they will be put on performance plans and have to take training on something.  I dunno, but I hope it's something that gets done and I can have a little bit of closure over all of this.  And again, I really hope none of my current docs think I am a bad person for doing this.  So far they are not even close to giving me the impression that they are against what I am doing, but they're not showing outright support either.  They're just super mum, and damn they do a good job of it!  Drives me crazy, but I know this is the way it has to be.  So I am going to wonder what they really think and get anxious thinking they're not too fond of what I am doing with this and then think less of me.  Ugh.  Hopefully they're on my side.......hopefully. 

Totally different topic and to end on a lighter note-- I was up in  Tahoe snowboarding this weekend and got some pictures for the first time post treatment.  They automatically got added to an album that has pictures as far back as 2011 from the same resort.  I was slightly amused by a few people (it was mostly people who have only met me in the last year or two and don't know what the pre op teeth looked like) who did a whole "whoa.... this is a totally different person," comment on some of the pics from 2011.  Not going to lie, it's nice to see the difference after this really long and tough journey.  I try to enjoy those moments and be thankful for what I've got now, but at the same time it always comes back to "but it wasn't worth your 7-8 front teeth."  It's the truth.  I would have never traded all of my front teeth for this, but it is what it is.  Here are the pics!