Went back into my ortho on Thurs to finish up the photos for my updated records.  He already had the surgical molds back but not mounted.  They took the photos and he mounted the molds.  The look on his face did not look so promising anymore.  His giddy optimism like he almost liked the challenge of trying to fix it kind of disappeared, and he said he's had post op cases as tough as mine and he's been able to 'fix' (I say 'fix' because in reality he's just going to make things good enough, in my opinion) it, but also said he's not sure that is the best way to do this for my case.  Maybe he realized how bad it was when he saw the molds and that combined with the fact that I don't have another year or two to sit in braces to let him fix it due to the signs of root resorption in my top front incisors is making him think twice about doing the work on his end, which would be lengthy and involved.

I got a copy of the 3D scans/xrays he took, and for the life of me can't figure out how to get the view of that cool xray I saw in the office.  So, I'll post that later when I can figure out how to pull it up off the disc.  But, even in the view I have now (almost looks like an MRI in vertical cross sections of my jaw/teeth) I can see how badly everything is shifted to my right.  Not only do I have the cant, but other planes are shifted as well.  Picture a center line where it should split your two front teeth-- well, mine is pretty much a whole tooth over to the right.  He said it was off 2-3mm in the last appointment, so that sounds just about right.  I almost feel like not only is my top jaw shifted vertically where it slants down to the right, it's also almost shifted horizontally too far over to the right.

I've been in tight elastics on my left since Weds.  For the first time today, I actually do feel improvement in my bite.  That's given me a little bit of hope.  I didn't have any hope before this because even though I was in elastics, nothing was moving.  If anything it felt worse.  Well here he thought he put me in tight rubber bands when I left the office two weeks ago, when really all I had was the loose rubber bands that my surgeon gave me, so they basically did nothing.  My teeth move very fast, so when there wasn't any improvement, let alone worsening, in those two weeks, I got concerned that this couldn't be fixed.  I still don't know how he would move the teeth on my right to fix the cant.  I've read about TADs (temporary anchoring devices-- these screws that are put in your jaw with springs attached to them that connect to the arch wire to pull teeth upwards in the vertical), but again I wonder if that will just impact those teeth, making them shorter, and it will just cover up the real problem which is a cant to the whole jaw.

I'm continuing to get feeling back in my chin.  It's still numb, but not dead numb.  More so numb and tingly and I feel like it's shrinking from the outside in towards a spot in the right/center of my chin.  I can itch now and get satisfaction from the itch, and most of the time can even feel food or liquid on my chin.  I'm going to be so bummed if I'm on the way to getting all or most of my feeling back and they have to pull me back in for a revision and I end up permanently loosing some of it the second time around.  Only other issue I have is I've been waking up puffy and swollen.  I've been back on my morning shifts which start at 4:45am.  I never sleep well before those since I'm anxious I'll oversleep, and with all the added stress/anxiety with everything going on, I think I am tossing and turning on my sides and irritating my jaw a bit.  My left side has also been sore, and I wonder if that is the elastics irritating that side or if the jaw is just more sore over there to begin with.  It's the side I have a big lump of a hematoma on in the lower jaw where I ripped some stitches and got an infection.  I feel like I'm even sore under that spot and under the break in my lower jaw-- like where your glands are, except along the jaw line under there.  It's probably a combination of all of the above.  I did 15 mins of icing and 15 mins of heat this morn.  That seemed to help.  The lower right side has been great-- no issues there and feels like I never even had surgery!

A few pics to kinda show where everything is sitting right now.  They're not the most flattering (especially looking up my nose!), but gives the gist of what's going on at the moment:

Well, not quite 3 hours, but today's orthodontist appointment was a LONG one.  I started at 10:45 and didn't leave until almost 1.  I got new records taken (pictures, xrays, measurements, etc) and new surgical molds done.  The whole thing I went through with the molds right before surgery had to be redone today.  I think because they are seriously looking at what is up and if I have to get bounced back to the surgeon.  I guess that is a good thing.  I'm glad they are looking at this from every angle.  The xrays I got was this awesome new 3d machine.  The xray looked so cool!!  It can be rotated on all axis for a 3d view.  I wish I could have just sat and played with it for a few minutes, but I had to jump back in the chair.  I am going to try to get a copy to post, and hopefully I can get some software on my laptop to allow me to rotate it because it was just freaking cool to see.  The plates and screws in my face were really pronounced on this 3d thing.  Kinda weird to see all that hardware in my face.  All of it looked like it was in the same position as my post op xrays, so I guess my theory of something loose or broken to cause this crooked jaw can be thrown out the window now. 

I got some bottom brackets rebonded.  Rebonding brackets always sucks, but it sucks more post op because those retractors they put in to hold your lips back get shoved in against fresh incision sites that just had stitches fall out, and you can't really open that wide still.  Same with the molds-- was a little tough since I'm not opening all the way yet.  And I was so afraid they would pull my jaw off my face when they went to take those mold trays out (those of you who have had impressions done will know what I'm talking about with the force of those trays coming out!), but they were super gentle and took their time with me and everything was fine.  The  measurements sucked.  I didn't like what I heard for the most part.  My overjet is at 3mm, which is the top end of normal.  I know it definitely does not feel as big as what I had pre op, but I was shocked to hear 3mm.  My top midline is off 2-3mm to the right, which coincidentally is how far my jaw is canted to the right.  Pretty much the whole thing, midline and all, is just shifted over to the right in a bad way.  He put the cant about 5 degrees (I think that is what he said-- I'll have to double check).  I don't know how bad 5 degrees is, but I know it looks pretty bad.  I think the only positive I heard in all the numbers was that I could open up to 33mm.  I wasn't even trying super hard to crank open, but I think 33mm is pretty good for 6 weeks post op.

I think they are getting the molds mounted and he'll send all the new info up to my surgeon.  I don't know how she'll look at the molds since she doesn't have them in hand.  Maybe I'll take them up on my next follow up.  I don't even have a follow up booked with her-- or my orthodontist for that matter-- until they look at all this new info and figure out what the plan is.

I've been trying to find more info on my situation.  Been looking for blogs to see if anybody else has been in my shoes or at least similar to my shoes.  I found this today and it gives me a little hope:

http://jackedupjaw.blogspot.com/2010_07_01_archive.html


Speaking of looking at blogs-- I have a confession to make, and it's kind of along the same lines of the whole 'feeling bad about feeling  bad' theme in my last post.  I'm part of the blogosphere for all the jaw stuff.  I'm also on some forum groups and facebook pages for all of it as well.  I love reading other people's blogs about their journeys and hearing everybody's stuff on fb, but I just started getting a twinge of jealousy.  I guess I can call it jealousy.  I don't know how to describe it.  I am still ecstatic for these people and everybody gushing about their awesome outcomes and perfect bites, but part of me just gets even more bummed.  And I feel bad about feeling this way, but I guess this too is also normal/human.  It's tough being in the minority on this one.  Tough seeing everybody's stuff coming out the way I wanted mine to come out.  And speaking of minority-- one of the assistants in the office today said in her 12 years there she has only seen one patient get bounced back to their surgeon.  I like being different, but this is not the stand out group I wanted to be in this time.

I have to go in for pictures to update my records tomorrow.  Maybe they'll have news on the molds and xrays, but I wouldn't expect to get any news on that realistically until next week.  Here's to more waiting.......

A friend said to me this week, "there is strength in vulnerability," when I said I was feeling pretty unsettled about everything.  Well, why am I trying to sugar coat it when I've been so open about everything in this process thus far-- I've been down right sad.  I don't want to say depressed, but I probably am.  I've been sleeping a lot this week and feel like I could sleep a lot more.  Probably opened one too many bottles of wine too.  I haven't really opened up about how I've been feeling this week because I didn't want to have a pity party.  I didn't want to invite people to feel sorry for me.  But in the interest of full disclosure of what is going on in this process for any future patients reading this blog, I guess I should make this post.

I've gone through something this week that I don't think has ever happened to me.  I've been walking around 24/7 feeling like I'm about to cry.  And then it just happens at any time-- it's hit me at my desk at work, on the way home from the surgeons office, in the car at various times, leaving my orthodontists office yesterday, standing in line at the grocery store.  I am  not one to cry in front of anybody let alone unsolicited in a public place.  It's a weird feeling, and I guess I really do feel vulnerable.  I'm just about over feeling sad and I'm ready to move on to whatever is next.  I guess I went through denial at first thinking it couldn't possibly be off and thought I was just smiling crooked due to muscle weakness/numbness, then sadness this week once the docs confirmed everything was off, so maybe anger and acceptance is next?  I don't want to be angry, but I'll take it over crying all the time because it's making my face swollen and sore, especially around the fracture and sites where the plates/screws are in my top jaw.  Makes sense since it's all connected to my sinuses, which were really compromised during surgery and are still healing.  I think I might be getting to the anger phase.  Yesterday I started getting thoughts like, "I've done everything that was asked of me.  Everything right.  I've gone above and beyond as a patient-- a lot more than the normal patient, I think.  How the hell did this happen?!?"  And then part of me feels bad for feeling bad.  I mean, I feel like I'm upset over a first world problem.  When I was standing outside of the hospital the other day after leaving my surgeons office, I stopped being upset for a second and thought to myself, 'there are people upstairs in an oncology unit probably deserving to feel much worse than I feel right now.  Suck it up cupcake!'  I've been trying to remind myself of things like that and shake out of the way I've been feeling, but again, for the first time in my life, I just can't control the way I've been feeling about something. That's kind of scary for me in itself.

Maybe once there are less unknowns I'll feel better.  As a scientist I always have to have my brain wrapped around the technicalities of everything and want to know what the plan is.  My orthodontist says he wants to get me to a place where we're both happy, but at the same time he says he has no clue right now how he's going to treat me to get me there.  That is freaking scary to a person who wants to know we have a plan right now.  I saw my orthodontist yesterday and he agrees it seems like my bite is getting worse and worse.  I really wonder at this point if I have some kind of relapse going on top of the improper positioning of my jaw during surgery....maybe that incorrect positioning made my muscles all wacked out and want to relapse quickly.  I think my ortho is concerned too because he ordered up xrays and new records to  look at on Weds and consult with my surgeon again and go from there.  I hate to say this, but I kind of almost wish for something like a loose plate or screw or something wrong that will make them just make a decision to go back in and fix everything.  At least there will be a plan.  I just hope my team figures out what to do and it will truly be the best way to go about fixing all of this.  I hope whatever they decide that it's the right decision.  Until then, I've got to find a way to get over all of this or else it's going to drive me nuts.  Every time I try to think about something else though, I'm quickly reminded that my bite is bothering me and it's worse than before surgery, and my smile is very noticeably crooked.  I feel like it's effecting my speech (and who knows, maybe my bite changing would do that, even if it was perfect it  might just be something to get used to), my chewing, and my confidence just overall.  It's kind of hard to ignore.  I'm just tired of being emotionally tired with all of this.

On a brighter note-- I think I've started getting more feeling back in my chin and lower lip.  I think I got just about almost all of my feeling back other than the lower lip/chin, and now I started feeling numb but less numb yesterday and I kept feeling like I had food stuck on my chin and there wasn't.  Kind of how my cheek slowly transitioned at first.  Hopefully that is a good sign.  It's already much better than what it was-- at least at this point if it itches, I actually get satisfaction from the itch.  Before this that was driving me nuts!!  I think I'd actually be OK if what I have is what I was left with, although it's dissapointing that it wasn't in return for a better bite.  And super dissapointing that it was for a worse bite! And another brighter note-- tomorrow is the sisters in skydiving event I am catering a bunch of BBQ for.  I love cooking, and even though I am pretty tired, I'm hoping it will get my mind off of things lately.  It'll be nice to see all of my friends at the dropzone too, even though I can't skydive. 

Quick pic of my swelling that has continued to go down, and a little glimpse at the crooked smile.  These don't even do it justice really, unfortunately. 

My surgeon got back to me yesterday after taking to my ortho.  She said my ortho is set on trying to fix it, so no surgery..... for now.  I'm still a wreck over this.  I have my doubts that my ortho can make this right since it's really a bone issue and not teeth.  And we're not talking about slightly being off.  This looks and feels like a lot off to me.  A few mm doesn't sound like much, but with this jaw stuff it's a lot!  When I got my wires off I was looking forward to lots of smiles, but now I can't stand to even see my smile because it's so crooked.  At this point I think I want my overbite back vs. this crooked mouth.  Again, there's no reset button on this.  It is what it is and this is where I am now.  My next ortho appointment is a week from today.  I want to sit down with him and talk this all out and find out exactly what his plans are.  I don't want to mask the real issue and end up with problems down the road.  I will continue to have faith in my surgeon and orthodontist, but I'm going to keep a healthy dose of skepticism in

I would say through this whole process I've been pretty good.  I was a super informed patient, knew the risks, and walked into surgery with a good attitude and remained pretty positive through most of my recovery and all the ups and downs thus far.  That all went to hell this week when I saw my ortho and he confirmed the cant to my jaw.  The fact that he thought he could fix it was giving me hope, but I've had a really bad feeling about all of this from the start.  My stomach has been in knots since Wednesdays appointment with him.  I saw my surgeon this morning, and she confirms everything as well.  No bueno.... like, seriously, this is no bueno.

I'm about 2mm or so lower on my right side vs. my left.  Could it be worse?  For sure.  The cant is not too noticeable if you're looking at me with my mouth closed, although I could swear my right ear is sitting lower because my glasses have not sat right on my face since surgery, and I have a few dimples on my left that I don't have on my right which is weird.  My surgeon wanted to consult my ortho today and talk about options and get back to me tomorrow.  I have a funny feeling I'm a surgical case again, and if it happens it's going to happen sooner rather than later so they can utilize going in and opening the fresh breaks which aren't even healed yet and retweaking everything.  That will be everything again-- the build up to surgery, the anxiety, the surgery itself, the crappy hospital stay, being wired shut.  A million things are going through my mind-- I've come this far and there is no reset button on this now.  I would say the bite I have now is worse than what I walked into surgery with, so why not try and fix it the way it's supposed to be done?  I guess part of me is worried about what if it comes out even worse?  Or what if I have more issues or worse side effects afterwards?  If I could be promised it would be right afterwards, I would have no issues doing this again.  It sucked, but it would be worth it to get it right.  The chances are low that you have results so bad or enough relapse that you need a second surgery, so they must be even lower that it could possibly be screwed up again let alone be worse off, right?

Speaking of the relapse and/or bad results-- which is this for my case? I'm not sure yet.  I think both.  I knew something wasn't quite right a while back, but then again I was dealing with a whole new bite and I didn't know what I didn't know and thought it was just the new bite, swelling, etc, and I was over analyzing and it would just take some time to get used to.  But I'm pretty sure this was done during surgery AND I think it's gotten worse since I was unwired.  Maybe not and it's just the swelling has gone down enough for me to notice it more, but I think it might be both things.  Regardless, the weird part is, I am not mad.  Should I be mad?  I mean, no surgeon who does 100's of these cases a year is not going to nail each one 100% every time.  If they get it right most of the time and come highly regarded, I think that is a fair thing to assess and expect; you take your chances and hope that you fall into that 'most of the time' category and not one of the odd few who end up not right after.  These surgeons are not Gods.  I went into this knowing there was a possibility of this happening.  So, no.... oddly enough I am not mad.  Honestly, I don't know how to feel right now.  Just kind of sad and super anxious, I guess.

I guess I'm putting the cart before the horse with this post because I don't have the final verdict on if they're bringing me back in for double jaw surgery part II until tomorrow, but like I said, I'm pretty sure that is the direction they're going to go.  Honestly, I think I'd rather them go back in and make it right instead of trying to fix it orthodontically-- dragging teeth down and back on my left side to mask what the real problem is, and could end up actually giving me a host of other problems like exposed root surfaces and everything else.  I'm in this already, so might as well see what they can do to make it right.  If it doesn't work after this.... well, that might be time to call it quits and accept that what I've got is what I've got now. Especially if I end up with no added numbness, pain, or issues.  If the bite isn't right after this, then that'll be all she wrote for me, I think.

Now to go home and occupy myself somehow tonight.  I'm a nervous wreck for this call tomorrow.

I've mentioned in a few posts about this crooked smile thing I have going on.  At first with all the swelling and everything else I just chalked it up to my muscles/face being off still.  BUT.... I had my suspicions it was actually my jaw and teeth lower on my right side and higher on my left.  I know my bite has felt super funny on the left side and my teeth are definitely not lined up.  Again, I wasn't worried since people usually get fine tuning done with the orthodontist post op.  I saw my ortho yesterday, and within the first two seconds of his assistants coming over to check out my new grin, they all said "wow, looks great, but you definitely have a cant slanting down to your right."  I was relieved to know that I wasn't crazy with my suspicions, but sad that I was right.  I don't want to be right.  What if this is something that can't be fixed with braces post op?  My midlines are also off.  Ortho said he thinks he can fix it, but it's going to take a lot of work on his end.  The assistants said it should be fixable too, but I just can't shake this bad feeling I have about this.  Even back with this xray I looked at it (even though I am no doc and don't really know what I'm looking at) and thought my jaws looked slanted/crooked:

I don't think it's a coincidence that my teeth are showing a cant where the left side is higher than the right, which is also exactly what is coming up on this xray.  My ortho rebonded a bunch of brackets on the top teeth and put me in elastics on the left side to start trying to pull everything over and down.  I feel like it looks even worse today!  I don't know if that is because some of the brackets are higher on one side than the other and it's just accentuating and making the slant more obvious, but my bite feels worse too.  My left teeth around my k9 tooth are coming down on top of each other tooth to tooth.  Again, I just have a bad bad feeling about this.  I'm worried sick that I am going to be pulled in to fix this with a second surgery.  I don't want to go through all of that again.  And I just cleared the hurdle of getting almost all of my feeling back around my top jaw, cheek, and eye, and I don't want to have to roll the dice on another surgery and possibly end up with numbness that will be permanent this time.  My orthodontist was pretty reassuring that he could fix it, but I'm not going to lie.... I have my doubts.  I have another follow up appointment with my surgeon on Monday, so I'll chat with her about it.  I hope they can give me a straight honest answer on what should be done about it.  If she feels really confident this can be fixed with ortho, then I guess I'll feel a little bit better about all of this.  I'll be praying to the jaw surgery powers that be that I won't need to go in for a second surgery.  If I end up in that boat, it is what it is, but I'm not going to lie-- I'm going to be pretty devastated.  :(

I can't believe tomorrow is 4 weeks post op!  I said that last week when I couldn't believe it was 3.  I guess time really does fly.  This past Monday was 2 weeks unwired.  I think I'm finally getting used to teeth being in new positions and all, and it really helps that feeling in my cheek has come back-- yes, even the outside too!  I have almost all of the feeling back in my cheek that was numb up to my eye ball and along my right nostril.  Only area I have that is extremely numb still is my chin and into my lower lip.  There is a small spot on my upper right lip, but honestly that is one of those spots that I could totally get used to if it stayed.  If I get more and more feeling back in my chin and get left with a few spots like that, then I'll be totally happy (and thankful) with that.  Eating is still tough, but a lot less tough than last week when even the softest foods just felt awkward.  I am still not tearing through chewing cuts of protein or anything, but I did manage a mushy meatloaf this week, and it was the best thing ever.  True story-- best. thing. ever.  Felt good to get a solid protein in for the first time in almost a month.  And it actually went down pretty easily, so make note fellow jaw surgery peeps reading this blog-- make a mushy meatloaf to east yourself into having an animal based protein again.  Otherwise, it's still been a lot of carbs.  Rice, beans, quinoa, mashed potato, some overcooked veggies, etc.  I did get something else surprising in-- shrimp!  It was border line too much to chew, so it basically went down whole in small bites.  But, at least I got it in.  Went good with the rice and beans topped with a home made chile verde sauce.  It was yummy, I won't lie.

Today was my first day back at work full time.  I would love to say that I spent a little of the last 4 weeks doing something fun, but taking sick leave really was 100% for sick leave on this one (and usually always is with me, which is why I had so much sick leave banked up to take off).  I'm still kind of tired since I'm not sleeping 100% back to normal and well yet, and still find myself in a little bit of a brain fog.  I'm still not quite getting the calories I need in, so that probably is not helping my situation.  I'm sure it'll be a week or two to transition back into the swing of things.  Feels good to start getting back to normal life a bit.  My swelling is down a lot (just a little puffy in a few spots) and most people's reactions are that they can't believe how well I look for just having had my jaw broken in a bunch of pieces a few weeks ago.  Overall I think I've been very lucky with my recovery, and for that I really am truly grateful.  Here are a few quick pics to show where I am with swelling and stuff-- and if you notice, I can almost smile now!  My stitches are falling out and muscles are starting to get used to their new home and loosen up a bit.  Still have a ways to go, but it's nice to smile a little more comfortably now.

That profile shot is really the first one I've taken since the swelling has gone down.  I never really  hated my old profile, but I do find myself looking at this one here and there and just thinking about it.  I don't think I love it or hate it.  I guess it's just different, but in a good way.  My face definitely looks a little more balanced and I don't have the upper lip incompetence as bad.  I'm still getting used to smiling.  I used to have to always calculate a smile by posturing my jaw a certain way, or making sure to not smile really big and uncontrolled where I would show a ton of gum.  It's going to take a while to break the habit of thinking about it.  Those pictures above are full smiles for me right now!  Can't believe I show normal amount of teeth!!  I keep checking my bite in the mirror to check it out and pinch myself to make sure I'm not dreaming that I see my teeth actually meet where they're supposed to meet, and also to nervously check to see if I have any signs of relapse already.  I just went through all this mess to get a perfect bite and I find myself super paranoid that it's going to want to slip back to it's old position.  It happens.  I've been really great with wearing my rubber bands and hopefully keeping everything in check.  I go to my first orthodontist appointment tomorrow morning, so we'll see what he has to say.  I can't wait for him to fix a few things-- my bite needs tweaking on my left (like, some of my teeth are sitting on top of each other instead of being in nice grooves and seated perfectly together), and I feel like my front teeth have shifted, both top and bottom, and stuff is a little all over the place and crooked right now.  I know being wired shut probably threw some things off and put pressure in certain places moving some teeth.  And teeth are REALLY engaged after this surgery, similar to the wilcodontics I talked about in a thread last year where they stimulate the root of the tooth to make the tooth move REALLY fast.   Hopefully they move back just as fast after my ortho starts tweaking things.  I feel good about tomorrows appointment.  I was afraid I wouldn't be able to open my mouth enough for him to get in there, but I'm opening wider and wider each day and feel like I've got good enough range for him to work with right now.  I also can't wait to get these damn surgical hooks off tomorrow.  One of  them looks like it's poking into my gum really good.... good thing I don't have feeling in my gums right there at this point!

It's probably a little early to do this, but my first before/after comparison for the profile.  Subtle changes for me, but that is good since I didn't want to do anything dramatic in terms of how I would look post op and instead just wanted to concentrate on fixing the bite issue.