Double duty appointment yesterday with my surgeon-- 1 year jaw post op follow up, and then a follow up on the hardware removal from last week too.  I just love seeing my surgeon.  Guy is just always so warm and friendly and for me personally I just love being in a place where I go to see him and it's all usually good news now.  And if it's not good news, then I know I am being well taken care of and got good eyes on me to fix whatever is going on.  

Luckily yesterday was all good news!  He's really happy with how everything is looking right now both on the 1 year jaw side and the aftermath of the hardware removal last week.  My stitches have fallen out and incisions healed VERY quickly. I thought this was going to be similar to the jaw surgeries where my stitches took 2-4 weeks to fall out and feel decent like this, but this happened in less than a week.  I was pleasantly surprised!  Only complaint I have about my incisions is my right side actually feels really smooth and uniform, and the left side is a little bit of a lumpy mess.  I know this was now the third time cutting through all this scar tissue and I can probably realistically expect that the incisions probably won't heal as smooth this time, but I for sure need to give whatever lumps are around a long time (like, it can take 8-12 months for scar tissue to work itself out and smooth out a little) before I start really getting worried.  It's up in the top crease of my mouth anyway, which is not some place I am feeling around with my tongue or anything so it's not even going to matter probably.  Anyway, if that is my main complaint, then that means things over all are going really well.  My swelling has come down quite a bit, but I am still quite puffy.  The shiner has quickly resolved itself and just a little black/blue remains under my eye(s).  I was supposed to take 1 year pictures/records yesterday and we're going to push it off until May when I should be all healed and not looking like a prize fighter from the hardware removal.  

Doc mentioned my bones healed beautifully.  Usually after a revision he expects some gaps in the osteotomy  but he said he didn't even see a single one.  AMAZING news since this has seriously weighed on me quite a bit through my healing.  After being opened up for revision and so largely non-union 2 years after my first surgery..... I was just worried there could be some biologic factor from me causing that.  My surgeon has previously assured me he was pretty confident it was all the twist/torque of the misalignment literally creating a separating force and not allowing those bones to heal right, but you just never know 100% for sure there.  He said enough yesterday to reiterate again that he's pretty sure it's 100% to do with the bones being that offset and not allowing them to heal properly the first time.  Phew.  This is REALLY REALLY good news for me and has lifted the last bit of heavy weight off my chest with all of this.  And it's also more evidence and confirmation that my first surgery was just THAT BAD.  It's good to get that validation here and there.  Still drives me crazy that I don't really get enough of that (hardly any of it really... my surgeon saying something like this is about as much as I get) and I still have closure issues because of it.  Anyway, only other thing was that I definitely did hear my surgeon correctly in my anesthesia haze last week-- the top screws were for sure loose.  Sounds like he's indeed happy now we went in and go them when we did because you usually end up with infection/abscess around screws that are loose in the bone like that.  Phew.  Now I feel more justified for saying these bothered me enough that I wanted them gone.  Not some crazy patient that complains for nothing.  I mean, I am pretty sure he knows me well enough by now to know that if I am complaining about something it means there is something valid and causing the complaint.  Overall I am pretty easy going and won't say something unless I absolutely have to.

Last but not least he checked my implant and he's super happy with what is going on there and complimented Dr. Lew's handy work on the crown.  He wants me back in May to do our 1 year records and then this was interesting to find out-- I am pretty much going to be a life long patient (or at least for as long as he's here practicing).  He said he'd like to see me in May and then maybe another 6 months after that and then yearly after that for the indefinite future.  Because of what happened, what was done, what my joints have been through, he wants to keep tabs on me and check my bite and monitor for any possible changes.  I for sure don't mind this at all because I am scared to absolute death of idiopathic condylar resorption that can happen to some patients.  Some patients are more suseptible than others.  I've read literature that mentioned relapse risk may be higher for certain cases, IE: class II open bite may have more relapse occurance vs. straight up class III cases.  Since my joints went through the trauma being malpositioned 2 years between surgeries AND I have suspected Ehlers/Joint Hypermobility Syndrome, it's better to keep tabs on me.  I'm actually really thankful and touched that he's putting in the time to keep tabs on me.  He doesn't have to do that and that extends WAY past his surgeon fees I paid him.  Most surgeons release you after 12-18 months.  Just another example of the amazing care I've gotten and continue to get the second time around with all of this.  I am forever grateful and reminded Dr. Karas yesterday to always please let me known if there is anything I can do for him or his office.  Hell, I feel like I owe him my first born or something at this point.  For now only thing I can do is offer up whatever I can do for them in terms of letting them freely use my case however they need (for study, teaching, outreach to other patients, etc) and remind them I am available to talk if they want to refer any of their other patients to me if they want to be peer to peer and get the skinny on jaw surgery from somebody who's been through it.  I know I was looking for that when I was first pre op and least I can do is make sure I make myself available for others to get that as well.

So that is that. I feel like we're really closing the main chapter on the jaw work with the records they'll take in May and my check ups will be much fewer and farther between after that.  Get the vaneer work finished on my front teeth and hopefully ride those bum roots out for as long as possible.  I joked with Dr. Karas that as much as I like him and his staff, it would be really nice to not have to be sliced and diced by him for a little while now.  He laughed and said for sure lets try to keep those front teeth as long as we can.  I'll probably check back in after the vaneer work gets done, but if that is not done before my next appointment in May...... I may actually be quiet on the blog front for a while!  I'll still be here.  Still checking any contact form submissions and chatting with people who reach out.  Kind of nice to getting to a point now where things are calmed down with all of this. I deserve it after the last 4 years of absolute hell!!Idiopathic condylar resorption

What a week!  I was looking forward to getting my implant crown in and FINALLY getting these bothersome plates/screws out from around my nose, but this week ended up being a doozy.  Was in Tahoe last weekend and my husband was sick as a dog.  Then I came down with it like a ton of bricks.  Nasty sinus/ear/chest infection kind of thing.  I have no clue how I pulled it off, but I was able to tough out sitting in my prsoth chair for the crown and then get to my surgeon yesterday to be well enough to still get the hardware out.  Phew.

So, lets start with the crown.  I feel like such an asshat going in to my prosthodontist's office when I was REALLY sick, but this appointment was dependent on everything else I had scheduled this week.  My surgeon didn't want to take the hardware out unless the crown was done and put in, and then all the other appts I had for follow ups and stuff after would have had to be rescheduled too.  I already had the time booked off work.  It would have been a mess to reschedule all of this.  So, I owe their office some donuts when I go back since they took my sick butt in and dealt with me.  But this crown.....wow.  I didn't realize how incomplete my bite felt until this thing was in.  That little bit of off I had this whole time where I couldn't get my left side to feel settled-- it was this missing tooth!  Duh.  Makes sense, right?  My bite feels complete.  I feel comfortable.  I feel whole.  My muscles are calming down, I am clenching less, and my headaches are better too (despite the constant sinus headache with the pretty severe sinus/ear infection thingy I had going on).  I've had a smile on my face all week after this got finished up.  I go back in two weeks to get the final check on it and they'll give it one more crank down on the implant post and then permanently fill it in and be done with it.

The plates and screws around my nose came out yesterday.  I didn't sleep well Mon night ahead of this.  I am not really worried about it or anything.  This is a walk in the park (for me and for my jaw surgeon) compared to both jaw surgeries and all, but it was just seriously giving me the heeby jeebies thinking about how much they were going to be stretching my face to get all the way up to just under my eyes to take these plates and screws out.  So, get in and they start some nitrous to make me chill before they get going with an IV and stuff.  Nice surprise.  I wasn't expecting that.  Normally it doesn't really hit me, but this time it hit me and I was SUPER fine with that! ;)  Dr. Karas comes in and I was just comfy and good to go.  It's so nice to be in a chair and have trust again....finally!  He's just always so warm and welcoming when he comes in to see me and I really love it.  So, I felt pretty good drifting off in his chair yesterday.  This IV anesthesia was weird.  I didn't feel rested like I was all the way out for this one.  I felt like I was aware of most of it, but at the same time I can't remember details past them starting to squirt a few things in to my mouth just as I was drifting off.  And the 45 mins went by way too fast.  Not instantaneous like usual, but way too fast.  So, I guess I was out.  I also came around very quickly. I don't think I was in their little recovery chair for more than five minutes before I was wanting to be up and out the door.  I was just really glad to finally have this done.  

I have to see if this was a dream either the night before surgery (like I said-- didn't sleep well and had interesting dreams) or if he said this in my anesthesia haze when I was coming around, but I could swear my surgeon said something along the lines of it all went well and those sets of hardware were a little loose.  If that is the case then I for sure don't feel at all bad being bothered by them enough to go through the motions of getting them out.  Even if they weren't, it was still the right decision.  Just in the last day putting lotion on my face, touching under my eye, itching, etc, etc-- I am not feeling the screws sticking out and it's GLORIOUS.  And then this last week I've been sick, there is also a part of the hardware that sticks out through thin skin just inside the bottom of my nose and it makes me want to jump out of my skin a bit every time I wipe my nose and catch that screw sticking out there.  I can't feel that any more either.  And I feel less pressure (despite the pain/swelling right now).  I am just 150% happy I got these out!!  Speaking of pain/swelling, I definitely have some.  I stayed pretty well medicated and ahead of it yesterday.  My face down through my front teeth started to throb not more than 10 minutes after leaving my surgeons office and I could feel I was swelling.  Took something around 10pm before bed and by 7am this morning I was up and pretty sore, again aching down through my front teeth.  Otherwise, it just feels like somebody socked me one in the face good.  Pretty much what I was expecting.  Even with pain pills it doesn't really do much for the pain from the stitches around across the top of my mouth again.  The numbness out of jaw surgery is really a blessing in disguise!  I can full out feel all of this now.  Speaking of numbness, I actually do have some slight numbness on my right under my eye and in to my cheek (same exact areas that impacted me after jaw surgery), but it's really no big deal and I am sure will resolve itself again.  The right side is the side that bugged me more, and coincidentally it's the side that was more bruised/swollen/numb after surgery and is now again more bruised/swollen and is seeing some numbness.  I have a little shiner coming out under my eye on my right.  Again, all things I was expecting with this.  I'm sure in a few days I'll be feeling back to normal again and will just have to deal with the stitches that will be around 3-4 weeks probably.  So, get past next few days, deal with the broth/soft foods this week or so, and be onwards and upwards from there!

I see my surgeon for a double duty appointment next week-- my 1 year jaw follow up AND the week post op from plate removal.  I'm sure he'll comment on the implant too, as he should because it looks like it's doing great and his work is solid there.  I see my prosth for the final crown check in two weeks, and then after that we'll just schedule the vaneer work on the upper fronts. Only other thing I want to address with him for now is I think it's safe to shave just a smidge more off the back of my left K9 and lateral incisor. I still have a smidge too much contact there on that segment vs my other side which is very comfy.  After that my bite is going to be pretty damn dialed in, which is exciting to finally feel that!

Going to try to keep the text short since I am doing a Vlog update for this one.  I'm calling this 1 year post op since my 1 year in Feb is going to happen right after I get some plates/screws removed from my upper jaw and I don't want pictures/video of any of the associated swelling from that to cloud a true 1 year post op view and where things have settled.  I always say it's crazy to be in a position to be in good shape now XX months post op (or as good as it can be given the circumstances), and that is still true today.  So for other revision patients reading this (or just jaw patients in general) keep chuggin.  The process is long and many times not easy, but hopefully there are better days ahead when it's all said and done.

As always, have to give major thanks to my team of talented docs again.  I feel like at this point I should get a frequent flier card to my surgeons office, but I love that he is still involved in my treatment in multiple aspects.  And I appreciate them still entertaining my curiosities and questions just like they have from day 1.....which was 2.5 years ago now.  Nuts!.  Just the other day I emailed my surgeon to ask about a suture he used on my nasal base to close me up for revision and if he'd have to redo that during my plate removal surgery, and he got right back to me and seemed un-annoyed by yet another nagging question from me. lol  Same with my prosthodontist last week, who I emailed as part of our continued hashing out of plans for my doomed front teeth.  I know everybody is probably sick of hearing me gush thanks for what these guys have done for me, but after what I went through in my first round of treatment and the extremely bad place that left me in.... it's just tough to not feel this way towards people who really saved my ass in that respect. And saved it better than I could have ever realistically hoped for, let alone asked for.

Speaking of saving my ass... that means things must still be going well 1 year post op.  They are! :)  I'll dive more in to the nitty gritty on that in the video, but in general my bite is still solid, still have the lingering strip of tingles/numbness left over from my first surgery (with ZERO additional numbness from revision, which is amazing!), my opening is back to normal (with a little stiffness some days still), and I'd say my swelling is gone (probably 90-something percent gone).   Now that most of my swelling is gone I can see that I am left with the slight asymmetry on my left side, which was an item very well advertised to me from the very first consult with my surgeon.  BUT, looking back on pictures even before treatment, I can see I always had a more round and prominent gonial angle on my left side.  The disastrous first surgery results just enhanced it even more, and my surgeon was very honest with me from day 1 that after healing of the bones offset and bowed out on that side from the first surgery, it might be a little off still after revision and would require a third surgery down the road to go in and contour the bone on that side.  I am NOT at all going to entertain the idea of having more surgery for something so superficial.  It's something I notice and probably my husband may notice, but overall not a damaging issue and causes me no functional problems.  Will include a picture below to illustrate what I'm talking about, but you'll see it's not the end of the world at all-- just a little sunken in on my right side and a little prominent on my left. Not a huge deal.  My nose has finally settled out and yes, it's wider, but I'm getting used to that finally I think.  My septum is deviated from the first surgery still, but again, I am not really tripping all over myself to have more surgery any time soon and will leave it for now.  My hair loss from surgery has finally turned back around and it's not falling out like crazy anymore, and I'm finally growing out my pixie cut and hopefully have my thicker hair back for the first time in 4 years.  Only complaint I have functionally is that I almost feel like my tongue doesn't have room in my mouth despite my lower jaw being moved forward.  I think this has to do with the fact that we extracted the lower incisor and shortened and pulled in my lower arch.  Hopefully I can someday get used to that, but for now I am having trouble feeling completely comfortable there without any tongue thrust.  That is something I probably had a problem with due to the open/overbite, but I am almost positive some of it is due to the lack of space on my lower arch right now too.  It's also doesn't help that my muscles still don't feel completely natural in this bite yet.  I still have some days with bad clenching and tightness, although overall it's still a HUGE improvement over what I had before surgery. 

Anyway, I am already starting to go over too much that will also be mentioned in the Vlog.  If I miss anything or anybody has any questions, feel free to shoot me a message or comment below!

Well... more like a wallop..... to my bank account, but don't even get me started. I was just going through charges from this week and I am already out $3,300 of the $5,200 of FSA I have set aside for this year.  It's only Jan 15th.  Ugh.  $2,800 is just for the crown on my implant.  Hoping insurance pays a little of that, but who knows.  Then the other $500 is for the anesthesia when my surgeon knocks me out to take the plates and screws out from around my nose in a few weeks (just scheduled that for Feb 7th). I am not even getting the option of going brave and cheap staying awake on that one.  Dr. Karas said he'd rather me out all the way for this since he's going to do a lot of stretching and tugging to get to these screws all the way up under my eyes.  ::shudder:: I ssssooo do not want to think about that right now.  But, I really am looking forward to not feeling these giant screws sticking out of the thin skin under my eyes.  Gives me the heeby jeebies every time I touch it, and some days its a little tender.  Ready to be done with that for sure.

It may sound like a lot of whining when it comes to what I've already spent in the first two weeks of 2017, but don't feel that bad for me.  I'm really not whining so much as I am venting, and venting here so that others going through similar things know they're not alone.  It's pretty well known that dental insurance doesn't cover enough, and that leaves many frustrated even for the most normal of routine work.  But, I am always thankful that I am in a position where I can pay for it.  I didn't used to be so lucky not many years ago, and there are many who are not that lucky now.  Our system definitely could use some change.  Anywho.....Yes, the costs to fix things that could be attributed to the carnage from my first round of treatment is irritating, most of these 2017 expenses so far are not because of my first round of treatment.  Both are expenses I was expecting, and they are TOTALLY worth it.  I am not seeing the cheapest doctors in the Bay Area, and that is a choice I made and do not regret for even a second.  Why?  Well, if you've read about what these guys have done for me, then you easily know why.  I'm getting the best of the best.  They are super experienced, knowledgeable, honest, skilled, have  more than earned my loyalty as a patient no matter what they tell me it costs, and I am getting what I pay for as far as I am concerned.  So, this one is easy to get over.  The stuff that won't be easy to get over is the rest of the years expenses.  $8-10,000 worth of restorations on teeth that are probably just going to need $20K+ worth of implants in the next 5-8 years.  That is work that (more than likely) is attributed to my first team of docs and the cowboy moves and mistakes there.  We'll cross that bridge when we get to it, I guess!

Anywho... I am scheduled to get the upper plates and screws out around my nose Feb 7th.  Not the set above my upper molars.  Those don't bug me luckily.  Neither do the lowers for the most part.  The week before that I get the crown on my implant, which has healed nicely in to the bone and my prosth and surgeon are happy with it.  Speaking of my prosth, he tells me the other day he's read in to my website here a little bit (Hi, Dr. Lew ;) ).  I gave all of my docs my website at one time or another.  I never really thought any of them would do much more than glance at it and maybe not even that.  I  mean, it's more than OK if they want to, but I would never expect them to take what is their precious time to look at it, nor would I be put off if they didn't look at it.  Regardless, as people know who have kept up with this story from day 1, I've got it all out there for anybody to see (including my docs) in all its rawness and honesty.  But, there are a few concerns with it when I know my docs are reading-- 1.) Have I done the medical side of this justice?  Have I correctly transcribed everything they've told me and everything that has happened to me?  and 2.) Does knowing that your work is being publicly showcased make them nervous?  Not that they should have any reason to be since they do above and beyond fantastic work, but I think it's human to feel nervous in a spotlight of any sorts, even if you're the best at what you do.  Hopefully I am not doing that to them.  And if there is a little of that, then hopefully they understand the impact this website has, especially for other patients doing jaw surgery research or other revision patients looking for information and/or to just feel not alone in a crappy situation.  And for me too.  This has been a great outlet for me obviously.

I'm almost a year post op.  Kind of crazy.  By actual days (I've kept track of my monthly progress on my google calendar) the year post op mark is next week, but by calendar date, it's not until Feb 18th.  I'll probably wait to do a blog post for that on Feb 18th, maybe with a Vlog to show where things are coming along and how healing looks at the year mark.  I might do that BEFORE I get the plates and screws out though, since doing it in the week or two after I might have some lingering puffiness still from the plate removal and it won't be a good indication of where I am at a year post op from jaw surgery itself.  In general though things are still going OK, but I'll wait to fill in more specifics on the year post op post.  So, I guess stay tuned for that post soon in the next week or two before plate removal!

I can't believe the end of the year is already here.  Another 1.5 months roughly until I'm a year post op.  Just crazy how quickly this all has gone looking back on this year.  I recently wrote in a blog post that I was thinking about my own healing and closure over what happened to me.  I was wondering if staying involved in the online forums and communities like I do was actually preventing me from getting that closure (whatever I can get anyway... I don't think I'll ever really have full closure over this since I got left hanging in so many ways) I need to be able to heal and move on.  While I like helping people and being able to share the knowledge I've gained from having to go through all of this, it also keeps me active and prolongs my own experience that I had instead of just finally putting it to bed and moving on.  So, I've been thinking about it.  Especially with the end of the year coming.  Almost a year post op for me and I do want to move on a bit.  I just couldn't pull back from things without feeling bad about it.  One of the online jaw groups I frequent had some bad juju going around for a few days last week.  People ended up getting pretty nasty.  Even I was attacked despite how diplomatic I tend to be online.  That was kind of my sign.  It's time to go.  Came at a time when I was already questioning if hanging around was allowing me to have my own closure from my traumatic experience.  Part of me does feel bad still, but less bad after the catalyst thread(s) that finally made me pull the trigger on this. 

I'm still going to have my website going (although updates less and less frequently probably) and will be answering any emails through my contact form.  Of course the people from these groups who need to find me know where to find me.  I'll still be around.... but just not in the same ways and to the extent I have been the last 4 years.  From a selfish stand point, it's really great to be in this position to where I can try and move on.  I deserve it.  I've done more than my time in this.  I deserve what closure I can get too.  So, while I love helping other patients through all of this, it's not worth it at the cost of my sanity.....which I felt like was suffering the last few weeks in some of the group posts when it got heated last week.  I've spent hours and hours and hours talking to other patients (both through my website and groups/forums).  I've had perfect strangers show up and I've offered rides and help.  I've even offered a place to crash.  I'm not playing a minature violin here saying I was made to do this and hated it.  Not at all.  Quite the contrary, I really enjoy helping others out.  If you've ever read that book, "The Five Love Languages," my language is acts of service.  This extends not just in my relationship with my husband, but to friends and other people I deal with as well.  So, doing these things makes me happy and it wasn't until recently that I did begin to question a little bit if it was holding up closure for me.  And again, I like helping, but not at the cost of my own sanity, which was beginning to suffer in some forums recently.  So, those are the driving forces right now in terms of pulling back and seeing where all of this goes.  Where post op life takes me.  Anybody readnig this and wanting to contact me through my website-- seriously do not hesitate.  I am still all ears and will lend whatever information I can for your situation.  But in terms of spending hours and hours on facebook groups and stuff, I am definitely pulling back there.

On a totally different topic.... I just came back from Santa Barbara to see a friend (who ironically I met through a jaw surgery group on facebook) who just had her surgery with Dr. Gunson.  It was weird driving down the roads there.  Last time I was there to see Dr. Gunson, I was in such bad shape.  Only 2 months post op, confused, in pain, and freshly abandoned by my treating surgeon.  I didn't know how bad I was on the drive in, and was completely shocked on the drive out after hearing the results were SO much worse than I even thought/feared.  Lots of tears leaving that place driving over the mountain pass back to the highway.  And driving out this time... it was just so weird to be at this place where I am fixed (mostly).  I was hopeless driving over that pass 2.5 years ago.  Never thought in a million years I'd be back and driving out in the condition I am in now.  It was a great feeling, but I also had some mixed emotions. I think it was also hard seeing my friend going through what she's going through.  I for sure understand.  Breaks my heart seeing people endure this, especially if they are enduring it at the hands of a doctor that screwed them over.  Unfortunately both of us are in that position, which is also another reason we've connected over all of this.

So, it was fitting driving back over this mountain pass.  At a time when the year is coming to an end and feel like it was kind of full circle for me on my journey.  It was the place I went to to start my revision process in June 2014.  And I drove out of there now at the end of 2016, class I and damn near perfect out of revision, and hopefully leaving those memories behind in the rear view mirror of that mountain road I traveled over.  I think this is a good time to start moving on.  So, here is onward and upward in 2017.....which I still can't believe is just around the corner!  Have a safe and happy holidays, friends! 

Next week marks 10 months post op.  I saw my surgeon for a follow up on my implant the other day and was scheduled for final records with my ortho afterwards.  Both offices hit on the topic of "what are you going to do with yourself now that we're tapering off with treatment?"  I don't know, but I know it will be weird.  For the first time in 4 years I won't be shuffling back and forth between this many dental and maxillofacial professionals all the time.  At this point it's become my normal, so it's definitely kind of weird.  I keep feeling like I am missing appointments and constantly checking my calendar.  It's also kind of sad.  While I am happy to be at this phase of treatment where we wean down to eventually never being seen by these guys again (if I can help it), it's sad to say goodbye to two doctors who will have such a profound impact on the rest of my life now.  They are definitely not people I will ever forget, and if I had to guess, my case is probably not one they are going to forget either.  The ortho probably only gets a handful of surgical cases a year, and can probably count on less than his two hands how many revision cases he's had in his career.... let alone a revision case like mine.  My surgeon obviously sees more surgery cases, but only a handful of revisions.  Not a club I wanted to be a part of, but I am. 

My surgeon was smiling ear to ear again when he saw me.  Remarked that I look really well, my bite is solid, and he's happy with the way the implant site looks and said I'll come back in Jan for him to check the integration in to the bone.  If all looks well, then I get shipped off to my prosthodontist for my crown.  I have to agree with him on the looking well part.  It wasn't until after I got my records from my ortho after that I saw them and said, "wow, I was still pretty puffy in the 6 month post op records I had in August." (See those records here.  I thought I was just gaining weight in my face, but I am the same weight as the records taking yesterday at the bottom of this post and I see a bit of difference in my face for sure) Makes sense. I feel like I had that final settling and lingering puff drop off around 9 months post op last time, and here we were now almost 10 months post op and I think it's finally left me again.  I just didn't realize until comparing the photos.  Crazy how long it all takes!  So, all in all I can see why he was really happy with everything.  Even though this wasn't a jaw appointment, it's hard to not chit chat for a minute about it.  I told him my numbness is still doing great, and if anything, I can swear that the numb patch on my lower right lip/chin is even improved a smidge.  He mentioned I may have had a little compression on the nerve there and he freed it up with revision.  I finally mentioned to him that I am not feeling natural at all.  My muscles don't feel relaxed enough and overall just not relaxed/natural feeling.  He reminded me that I am not only getting everything to settle in a new bite different than the bite I had for 30 years, but we also threw everything for a loop being in yet another new position after the first failed surgery (and a bad position at that), and by the end of the two years when it just started to get settled in to it's new home, we go and reset everything again.  So, like everything else, it's going to take a lot of time for everything to calm down after what it's been through.  Understandable, and I already knew that, but it's always nice to get comforted by your surgeon and reassured what's happening is OK/normal.  He also gave me his blessing to be on my snowboard for the season starting soon in another month or so, and while he was less excited to give me the go ahead for this, also gave me his blessing to get back on my road bike..... but be VERY careful.  Needless to say, I left the office is pretty good spirits!

I head over to my orthodontist after for final records.  FINAL records.  Crazy to be at this place after 4 years of hell.  Quick few xrays and some photos and we were done there.  Chatted with my ortho a minute and asked him how  much longer for the 24/7 retainer wear.  He said typically he will start pulling back around 6 months after debanding, but given everything that's been done to me and the mobility of my teeth.... he suggests wearing it as often as I can during the day still.  I already figured on that myself, so that will be that.  They said if they don't see me before (to get my retainers adjusted with the implant and veneer work), then expect a card in the mail in about 3 months to make a check up appointment in 4 months from now.  So crazy walking out of my ortho's office with no appointments on the books.

This is all still an emotional roller coaster for me.  I truly am sad to start winding down and saying goodbye to my docs.  I'm also going back and forth on how I feel about everything over all.  Some days I am like "omg, I love this new face.  So worth going through all of this for this amazing bite!" and then other days I feel more, "meh, why did I do this to myself?"  The truth is honestly somewhere in the middle for me.  I'm also still trying to process my lack of closure.  I'm still really involved in the jaw community and helping other revision patients out.  In that mix, I've helped out more than a few cases that didn't turn out well from my first surgeon.  Doing this keeps it fresh for me and probably delays my closure and moving on, but I can't help but talk to these people and help if I can.  Nobody deserves to be hung out to dry by her with nobody to talk to like what happened to me.  I still fear I'll never get closure.  Short of one of my revision docs laying it all out for me and confirming to me what happened was that bad, or having my first ortho or surgeon reach out to admit the wrong doing and/or apologize..... I just don't think there will ever be closure otherwise.  As time passes I'll hopefully think of it less, but there will always be a hole in my heart where there is still this unknown about what happened to me and why. 

I'm also dealing with the decision on what to do with my teeth now.  I whitened them and they look much better, but I am still dealing with a patch work of bonding on the upper fronts.  They really could  use the vaneers, but the thought of dropping 10K on vaneers that are basically going to be temporary for me until I am forced to do the 15-20K worth of implant/bridge work eventually...... I really don't know what to do. :(  That is a lot of money, and I am starting to think it's not worth it.  I notice the pieced bonding, but in pictures and just carrying on in normal every day life with people, nobody notices.  I am leaning towards letting them be at this point.

Here are my records taken the other day. I also put together a 3 layer before/during/after comparison.  It's really fascinating being able to look back and see how this all evolved.  Part of me wishes I would have done that 1 picture a day video to REALLY see the changes.  Oh well, that is an idea for somebody else pre op reading this blog!

I've talked about my issues with the top essix retainer in more than one blog post. I knew before I got it that it was going to bug me because when I had them last time for my short stint between braces treatment.... they bugged me!  Go figure.  But, I let my ortho give it a whirl.  I am not one to dictate to him what we should in terms of my treatment with retainers or anything else.  So, here we are almost two months later, and I am confident in saying I gave the essix enough of a shot.  Time to go to the hawley.  I am over the constant clenching and headaches from the essix.  Luckily my ortho didn't bat an eye when I asked him if I could be fit for a hawley.  Took a while in his chair to get it shaved down and a good fit, but hot damn does it feel nice to have my teeth more uncovered and the biting surfaces unadulterated and able to touch comfortably.  Right away I was not clenching much and my headaches are now gone again.  So, for my peeps reading this in retention phase, don't hesitate to try a different retainer!  Get one that is right for you.  You're going to be in these for a long time.... like the rest of your life, so might as well be comfy!

I saw my surgeon for a check up on the implant.  All looks well.  They snipped the stitches and I was good to go.  I have to go back in 5 weeks to test if the implant is taking to the bone yet.  I'll also stop by my ortho that day and do my final records with him.  After that, I won't see anybody until February to start following up for my 1 year post op appts.  It will definitely be weird to go 3 months without seeing my docs.  That will be the biggest break from that in 4 years. 

On a totally different topic-- I went on my first big post op trip.  Met up with some of my sorority sisters in Vegas for the weekend.  I had a wide range of emotions through the trip and I am not exactly sure what they are all tied to, but I know some of them are tied to everything I've been through the last few years.  It made me realize how different of a person I am now, which who knows, maybe I'd be pretty different whether I went through this or not.  People change as they get older, but in terms of the kind of different I am now.... I am pretty sure it can be directly attributed to all of this.  I kind of felt like I wasn't the bright cheery party girl any more.  I was usually the one to instigate getting in to trouble and staying out all night.  Instead I felt like the old grandmom on the trip who wanted to call it a night and get to bed by midnight.  Oddly enough, I felt less comfortable in my skin now than I did with my raging buck teeth in college.  Not that I was looking for a huge confidence boost there (like I said, I already kind of had it and was comfortable in my own skin before this), but it was just interesting to note that I felt LESS comfortable now after going through all of this, which all was supposed to yield these physical changes that should make you feel more beautiful and confident.  Just goes to show you that it doesn't come by flipping a switch on some surface changes.  It's a problem that runs much deeper, which is why I caution pre op patients to not sell the farm on this surgery.  Emotionally you may feel the same after.  

I do think I am different now because of what I went through.  A type of PTSD recovery that I am going to need more time to swing back around from... if I ever can.  I feel like this experience has made me a little bit of a mean/bitter person now.  Not the basket of fun I used to be.  In full disclosure, there is more going on. I haven't talked about it much publicly, but I found out a few months ago that my joint(s) issues (first the jaw, then the knees, then the feet, and now some other things) are not one off issues.  That I won't be able to fix my jaw and move on.  I have some autoimmune issues going on that is going to leave me with life long chronic joint pain and laxity.  I've recently been told I'll never run again, and there is really no surgery to fix the pain that I am in, because having surgery with this issue usually just makes it worse.  Had I known this, I probably would have never had my jaw surgery.  So, lets just hope that I didn't cause my TMJ's to get worse or looser after this.  So, on top of dealing with the trauma associated with going through this jaw fiasco the last few years-- being severely wronged by my first set of docs, having to endure treatment a second time, the stress and anxiety with all of that, and then more recently the stress and anxiety around finding out I am losing all of  my front teeth.... it's just a lot to process.  Hearing you'll never run again is a tough pill to swallow.  Hearing your joints are just going to continue to deteriorate badly on you is a tough pill to swallow. I am a REALLY active person, and this is almost a death sentence for me.  It's leaving me with a lot of anxiety and depression over thoughts like, "how much longer will I be able to backpack?  Snowboard? Skydive?"  Rightly so, it's a lot to take in.  It's still new and I am still trying to understand it all.  Admittedly it's caused some depression recently.  I was very much looking forward to curing the one off problem I had (thinking my jaw was isolated, then my knees were isolated and just bad luck) and be able to move on with life as normal.  It's not going to be the case, unfortunately.  It's going to take time to wrap my brain around that, so I probably shouldn't be too hard on myself for being a little bit of a party pooper in Vegas.  It was just bad timing right now for a trip like that.  Oh well.  Just take each day as it comes and try to continue processing everything that is going on.  That's all we can ever do.

I felt like it was a huge drop off of metal on my films after the braces came off.  But now I've got a new addition:

Got my implant done on Mon.  My surgeon said have a weekend off for recovery, and I am glad I scheduled this on my work Friday.  This hurt worse than I thought it would!  It might have had something to do with the fact that I went out for Monday night football and talked and chewed too much, but regardless, I was pretty damn sore come Tues.  The feeling of being tender to the touch, swollen, and gums all stitched and sore totally gave me dejavu of the break in my jaw after surgery on that side. Was kind of the same feeling, and now I realize how much of a blessing in disguise the numbness is after jaw surgery!

So, first implant finally out of the way.  As for the others?  Still in wait and see mode with those.  I check in with my prosth again later this month.  I see my surgeon on Tues for a check up of the implant site, and then get my hawley for my top teeth from my ortho. I am excited to get that and hopefully relieve some of the clenching/headaches I've had in the essix.  I see my ortho in a few weeks for my first official retainer check, although he kind of got an eye ball on me the other day when I was in to shave down the fake tooth on the lower hawley since now I have a post sticking up out of that space.  After that....nothing on the books for the rest of the year.  So weird!  I think this is the most calm/dead my ortho/jaw calendar has looked in over 3.5 years.....which is awesome! :)

Yesterday marked 8 months post op.  It really is crazy how quickly the last 8 months have flown by compared to the 8 months that went by leading up to surgery.  I feel like that took FOREVER.  So, where are we at 8 months post op?  We're getting to a point where there are no earth shattering major changes.  I feel like around that 6-7 months post op I dropped another bit of swelling around my nose.  I've got some puff left, but it's really not much and in all honesty, it's getting to a point where I have to wonder what is puff and what is just additional weight from the extra 10-15lbs I am still hanging on to that need to be lost.  For the most part I feel pretty good.  Still sore/stiff some days, especially days where I start early for work and/or do a lot of talking that day.  My opening is pretty much back to normal and has been for a good while now, but still have some stiffness/hesitation cranking open sometimes.  Both discs have been happy and I only get a little subtle crunching every now and then.  I'm eating pretty normally for all intents and purposes.  Still taking it easy on the loose front teeth.  My surgeon peeked at my latest pano last week and he said we're not completely filled in yet on the bone healing, so we're still chugging along there.  And those upper plates/screws that bug me to the touch he is still agreeing to take out after the year post op mark.  Like everything else in this process, all of this just takes time.

Speaking of my surgeon, I am heading in on Mon to get my first implant.  Should be straight forward shot on my already missing back molar.  Luckily I've got some soups frozen still from jaw surgery, so I'll just use some of those for a day or two and be good to go.  I need to stop at my orthodontists office on the way home and have him shave down the fake tooth they have keeping the space for the implant.  I asked my ortho to make me a hawley retainer for my top teeth too.  I've given the essix almost two months now, and it's been 5-6 weeks of clenching and headaches. I don't think it's going to work for me.  It will be great to have as an extra retainer on hand, or to wear in situations where I don't want the wire of the hawley showing across my front teeth, but otherwise I am very much looking forward to having the hawley and allowing these teeth to breathe and let the chewing surfaces of the top and bottom teeth be able to rest together naturally.  After that I'll probably check in with my surgeon to check on the implant site, and then I have my two month retainer check with my ortho the third week of Oct.  I am not sure when my next jaw follow up with be... or if there will even be a formal next appointment of any kind for it.  If not, then I'll be seeing Dr. Karas beginning of Feb 2017 to address taking my upper hardware out.  Can't wait to get those screws out of my under eye!!

I had an appointment scheduled with my surgeon yesterday to go over our implant plan for my back molar.  I really didn't need another implant consult, but I went ahead and let them schedule me for it since I wanted to catch up with him on a few things anyway.  The implant stuff I am more than spun up on at this point, but I never really got to hear from him how the bones were healing at my last jaw check up (that got cut short thanks to my implant scans and molds taking up the whole appointment), so I wanted to get the skinny on that.  I also was hoping he'd chat with me a few minutes about the latest and greatest on something I recently told him I did, which was FINALLY put the complaint in against my first surgeon with the CA medical and dental board. 

Yes, I finally did it.  It was a long time coming, and I decided to pull the trigger on that now that my medical issues, which were my main focus first and foremost, have now been fixed.  I wasn't going to pull him in to this at all.  He's already done enough for me and I don't need to bother him with my first surgeon baggage, but as part of the investigation process in to my complaint, the dental board said they may need to talk to all of my treaters and pull records.  Ugh.  So, as a courtesy, I let him know that he may be contacted and I apologized for having to drag him in to this at all.  He seemed OK with it and said he'll give the board whatever they request if they contact him and request it.  Phew...good.  He's not put off by me doing this..... or is he?  Does my surgeon now think I am a complain for nothing patient?  Sue/complain happy over nothing?  I mean, now my mind is spinning because while I've had enough people tell me that what happened to me was WAY past an honest mistake.... I still have never had an actual doctor say it to my face (well, outside of the guy at Stanford who then did the total 180 on his statements), so I still second guess myself here.  I'd like to think I am correct.  That what happened to me was way below the standard of care and just not right at all.  That I am completely justified putting in a complaint over what happened to me.  But, it really bothers me to think what if I'm wrong?  What if I'm wrong and now my surgeon just sees me as a threat and more hesitant to treat me?  Like some sort of ambulance chaser sue happy person who complains just to complain over anything and everything?  Know what I mean?  I'm totally NOT that kind of person (at least I think, but I'm obviously a little biased lol).  Hopefully he knows me enough by now through the last 2 years to know that I am a more than understanding and pretty easy going patient and definitely NOT one of those patients. 

I'm probably over thinking it, but it's tearing me up inside that I possibly could cause my surgeon to think less of me or be put off that I'm doing this.  And I am never going to know because he's never going to speak to the level of care I got with my first surgeon; letting me know that I am not crazy and fully justified going through with this. Or even a nudge saying he thinks it was all a normal complication(s) and honest mistakes and I should just move on and it's not complaint worthy.  But, I am never going to know.  It's almost bothering me to a point where I feel like I should just call the dental board and retract the complaint I put in, just so I can end this anxiety I have over my surgeon possibly thinking less of me over it.  But then I'll always wonder what if on the complaint and if that was in fact the right thing to do.  I just wish I could get some guidance on what the right thing for me to do is.  It's a lose lose situation honestly, and I have no clue what to do now.  :(

So, left the appointment with anxiety and a little bit of sadness over all of that.  At the same time though, I was glad to get some good news and left with happiness over that-- my incisors are firming up, and doc is happy, saying most of the teeth (outside of that bum lateral incisor) are barely mobile now.  AMAZING news.  So, continuing with wait and see plan for that.  And then even better, my implant actually gets 60% paid in to it from my dental insurance!  Waahhoooo!!! Super awesome unexpected surprise!!  So, about $900 for the implant and I am not sure what the crown will be yet.  We'll cross that bridge when we get to it, which won't be until next year.  Implant goes in first week of Oct and then we'll wait 3 months to let it take to the bone before putting the crown on it.  In Feb we'll revisit taking my upper hardware out, but for now doc seems happy with the bone healing on my last pano.  We're not completely filled in (which seems to be going slower than last time and he reminded me that is normal for a revision) and fully fused, but we're slowly getting there.  Phew.

So, mixed emotions.  So happy all is going better than we thought it would be going over all.  My front teeth have some hope now (more than they've ever had!) and my bones continue to slowly heal and go in the right direction.  I am not sure if I will ever feel good over the whole complaint thing going on.  I so badly just want to feel better knowing I have my surgeons support and he doesn't think less of me at all for doing this, but I am not sure I am ever going to get confirmation of what he thinks I should have done with this either way.  I am going to have to accept that and just hope that he does fully support what I am doing with this, but he just can't violate his standards in terms of not speaking to that at all.  I don't blame him.  It's smart.  But it's definitely not helping in terms of my mental/emotional anguish over this.