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Mini Update... Because I Am Too Excited To Wait Until Next Week

4/25/2016

8 Comments

 
I was going to wait to make a post next week after I saw my ortho, but a few house keeping notes from this week.  First off, my nerves are going crazy.  But, crazy in a good way.  My chin has been driving me bonkers the last week or two, and then every now and then I get these sharp pains like somebody stabbed me with a needle with an electrode on the top of it and it just goes off for a few minutes. And then the itching!!  Gggrrrr...the itching!  These were the nerve zingers I was expecting the first few weeks post op again and didn't really happen much.  Now we're a few days short of 10 weeks post op, and I am getting them.  And everything is opposite.  First time I got the zingers week 1-3 while still dead numb, and then slowly became less numb.  This time I have gotten more feeling back faster, but it happened without the zingers and now the zingers are hitting.  Weird.  Oh well, at least it all seems to be coming together finally.  Left side of my lower chin/lip is still tingly, but the kind where I am pretty sure I'm going to continue to get everything back on that side.  And then the edges on my right side have the tingles like they'll shrink in too. I am cautiously optimistic that I am basically going to get all feeling back after this surgery (well, at least down to what I started with, which was a numb strip down my right side of the lower lip/chin).  So, again, bravo to my surgeon.  Another thing he did well with.  I am pretty sure at my age in a revision surgery, there was a pretty damn high chance that I was going to have additional numbness, and it feels like I might get lucky on this one and get it all back.  Woohoo!  Huge bonus, as I was already at peace with the fact that I was probably going to end up with more numbness.  Actually love having good surprises on this journey for once!  Anyway, along with the other things coming back are my gums.  Holy hell... hypersensitive again!  My teeth are super sensitive too.  I absolutely hate brushing my teeth right now.  I've been cheating and brushing a little shorter, but it's all I can do to not go off a cliff over it!

And in other changes....  I am officially open 3 fingers!!!
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3 fingers!!
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"zomg, I can open 3 fingers!!"
I feel like I've been stuck a little over two fingers forever, and then in the last day or two-- bam.  3 fingers like a boss!  My right joint flared up on me bad earlier this week.  I was really worried again.  Pretty certain it's the disc slipping out and once it starts, then it has to have it's little fit for a day before calming back down.  So far no issues since, even when getting all the way open like this.  Hopefully that continues to be happy and healthy from here on out, but I wouldn't be surprised if it continued to have little flare up the next few months of recovery. 

And then.... then this happened: 
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first time biting clean in to pizza
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I literally wept over this pizza!
It was another one of "those" moments.  Not just for this revision recovery, but for the whole process to get to this point in general.  Class II patients commonly complain about eating pizza.  You bite in to it and drag ALL the cheese and toppings off in one bite.  Half the time I just do a fork and a knife to eat pizza so I don't get pissed off not being able to bite clean with it.  I was out at a concert with my husband the other night, and for the first time in my life, I bit clean through a piece of pizza.  No mess, no fuss.  This was on my list of wants after jaw surgery, and I got it.  I've thought about that moment for years.  So, even though I don't like to cry in public, I totally cried in public over this one.  They were happy tears though!  I even sent the bite picture to my surgeon and told him that so far the only undesirable surgical outcome I've had this time is getting a bite good enough that now all I want is greasy pizza that isn't good for my waistline!  He got a chuckle out of it, I'm sure.  Now next on the list is a sandwich or hoagie to bite through and get cleanly through the lettuce/tomato/etc in it without pulling it all out.  Not going to happen quite yet (especially with my loose front teeth), but I know I'll get there eventually.

Speaking of my bite, I decided to snap a few pics of my bite since I am updating this post with some pictures.  Of course I chose to take these after eating curry, but oh well.  Don't judge.  My teeth are still coming together nicely.  Actually had to email my ortho and ask what I knew was going to probably end up being a dumb question, but I did it anyway and figured worst case they get a chuckle out of it.  My bottom front teeth are hitting the back of my upper front teeth when I bite.  Since I've never had my front teeth touch in any way before, I wasn't sure if this was good or bad, so I had to ask.  Turns out it sounds like it's not an issue and the treatment coordinator who responded to my question did in fact think it was cute that I had to ask and got a chuckle out of it.  A few notes-- my teeth are not perfect.  My front teeth have some work left on them.  They're all kind of tipped (not proclinated or retroclined, but actually tipped in the direction like if you were waving with your hand) and need to be righted.  The loose tooth 7 needs to be extruded some more (you can tell it's shorter than the rest of the teeth), my ortho is still fine tuning my gum line, and my midline appears quite a ways off, but it's actually not that far off-- it's my nose that is crooked!  I've also got a tooth size discrepancy thanks to my first ortho bonding my two front teeth in the wrong shapes (one is bigger than the other), so that is throwing it off too.  So, hopefully that looks better after I get my deviated septum fixed and restoration done, but as it is now, I don't really care about it much in terms of the way it looks.  As long as my bite feels good and is functional, then I am good! 
I took some pictures of my bite in the same spot 2 years ago.  Actually almost two years ago to the day!  This is what my bite looked like 3-4 weeks post op last time:
What a difference two years, a round of good revision ortho, and a successful revision surgery makes!  Really sad looking at the bite pictures from the first surgery.  So sad!!

Anywho.  This was supposed to be a quick update, but those of you who know me or know me through this blog... you know my posts are never quick ;)  I see my orthodontist in a week and Dr. Karas in two weeks.  Crossing my fingers I can get out of rubber band jail a little finally!  I think that is what is making my right side all pissed off-- or at least helping that along in that direction on top of the normal aches/pains of healing.  We'll see!
8 Comments
Traci
4/26/2016 06:05:44 pm

How exciting to both the three fingers and the pizza! I'll cross my fingers your joint stops acting up! You've been through a lot and I don't want you to have TMJ issues! Take it from someone who's had both issues (bite changes and TMJ issues) severely that it's no fun! I'm really happy things are going so well for you!
Traci

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Ashley
4/26/2016 06:19:46 pm

Thanks!! I am hoping to avoid the TMJ issues too, but honestly if I have to rodeo this every now and then in exchange for everything else being fixed, then I am willing to take it and deal with it. I'm so sorry you have the joint issues. Now that I have felt a little of what the feels to have the locking/popping/etc, I don't envy people who have that going on :(

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Traci
4/29/2016 07:40:17 pm

Hi Ashley--
I saw my surgeon today and he explained what has happened with my jaw to have such a severe relapse in my open bite. My discs were damaged prior to my first orthognathic surgery. After surgery I was one of less than 1% of people who had bone remodeling after surgery due to my chronic TMJ problems. I was bone on bone with degenerative joint disease...my discs were pretty much gone. My bones remodeled after my double jaw surgery, because of the TMJ issues, resulting in an opening of my open bite again. He said a ramus osteotomy with braces for a minimum of three months is the only thing that will close my bite. My insurance doesn't cover anything jaw related but he's submitting as medically necessary as I only barely touch my back molars on each side and am unable to chew...therefore resulting in choking...and my speech is horrible due to the open bite. So now I wait to see what insurance will do. On a good side, my joints are healing from my last fat graft surgery in January and he measured my opening at 34 mm! The best in 3 years! Woo hoo! Do you know much about the ramus osteotomy" I had BSSO last time for my lower jaw but this one is BSSRO, I believe.

Ashley
4/29/2016 08:50:48 pm

Oh, wow! I knew there had to be some pretty gnarly stuff happening in the joint. In my last 3d scan before surgery, they did not I had some moderate bone remodeling as well. So, lets hope that doesn't continue after this surgery. Your bones are going to somewhat remodel after being relocated, but it's like resorption, if it just takes hold and keeps on going....well, you're in trouble. And honestly, sometimes there is no rhyme or reason for it! As for the BSSRO vs. the BSSO.... IMO, most patients NEED the ramus osteotomy, but most surgeons just do the BSSO. My revision surgeon by and large does a lot of BSSRO's, but when he cut in to me and saw how prominent my previous BSSO was (and probably how it didn't heal completely and I still had bone dehiscense... I think I am spelling that wrong right now but I can't think of the correct spelling for the life of me at the moment) he had to make the same cuts along the BSSO and abandon his BSSRO plans. It still worked out pretty well, but he would have rather done the BSSRO for sure. But, sounds like you have a plan, which is great news!!! Do you have a time line of when you can get all of this done?

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ashley
4/29/2016 08:51:56 pm

note** not not when I was referring to the remodeling in my joint

Traci
4/29/2016 09:17:25 pm

I'm having a hard time finding much information about the ramus osteotomy but searching...thanks for the information you passed onto me. To me, it sounds like the BSSRO is better for fixing the lower jaw when asymmetry is not involved but I'm probably analyzing this the wrong way. My lower jaw split when he did my BSSO so he had to go a new way and change up his plan slightly. What was better about the BSSRO for your surgery? Time line...he said my joints are stabilized after my last fat graft surgery in January so he feels comfortable performing the surgery anytime now. They say it'll take 2-3 weeks to find out about insurance...not even holding my breath with that but maybe he'll be convincing enough and SOMETHING will go in my favor through this process. I'll call my orthodontist on Monday and find out what needs to happen with new records/braces, etc. though I won't have them put on until I know I'm going through with it. This will be the 3rd time I've had braces in my life, 8th surgery in less than 3 years. From the sounds of it, June might be obtainable for the surgery...maybe? I have a two week class I'm taking at the end of July, singing, playing recorders, constant movement, etc...very intense training so I'm hoping sooner than later. If June doesn't work I'll have to wait till August and then I'll run into the school year...I'm so tired of recovering from the "latest" surgery.

Taryn
4/26/2016 09:11:36 pm

I am missing the same bottom tooth as you and just got braces to attempt to close it. I am so happy your teeth are coming along you've had quite a journey! But you are the first story I've encountered with that tooth missing so thank you for your updates !

Reply
Ashley
4/27/2016 05:57:19 am

Hey, Taryn! Are you missing the same molar or the same lower front incisor? I was missing the lower left molar (tooth 19) when I started treatment. It was always the plan to keep that space open and do an implant on it. The front lower incisor was pulled as part of my revision ortho treatment, so if that is your plan, then for sure check out my revision treatment posts from Jan 2015 on through current to see how that goes closing that space and what it looks like now after closing it and having surgery. I also had a hard time finding treatment cases to look up to see what the final result was with just 1 tooth being pulled. Ironically enough, I later found out my ortho's daughter had exactly this done and I was able to take a quick look at what her results looked like. Your midlines are off forever, but nobody can tell unless they are really staring at it since it's the bottom teeth.

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