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Third Postop Adjustment

5/25/2016

7 Comments

 
Going in for these adjustments has been a little different because they are just so damn minute.  The tiniest little fine tuning changes, which is why I think the appointment frequency has been shorter at 3 weeks.  Doc kept saying "I am really happy with your bite.  Bite looks great.  Just need a softer landing on those front teeth."  I think I can tell he's adjusted the angulation on my front teeth a smidge, my midline seems more centered now, and we're working on tweaking my elastics to give me a good balance where we keep everything tidy, yet prevent that right 6-7 tooth segment from clashing down on the teeth below it more than they should. Wires out, and my doc wiggled my front teeth.  Heeby freaking jeebies!!!  Gggaaahhhh!!  It's not necessarily painful or anything, but it doesn't give me warm and fuzzies, especially when it's somebody else doing the wiggling unexpectedly. But they felt really loose... like, really really loose.  They felt like how loose baby teeth felt when they came out when I was little.  Bleh.  Damn these front teeth.  :(  A bend or two in the top wire and back in it went with new power chains on the top and bottom. My lower wire has not been adjusted since late 2015.  I am going to assume we're done with my lowers and it's just being retained for the most part. Rubber band jail has been tweaked a smidge.  He still would like full time on the current elastic set up, but told me to use my discretion to get out of them for a bit here and there if that right side is bugging me a bit.  Just need a balance of keeping everything closed up and tidy yet not closed up too much on that side where I have too much contact between the upper 6-7's on it's lower neighbors.

I did a records dump from my surgeon.  I got in the habit of getting all of my records and having them after my first round of treatment.  I was using them for consults then, but now it's mostly just to have and to satisfy my geeky curiosity seeing things like my surgical report.  It's neat to read my treatment notes from all of my appointments in 2016, and especially cool to see the surgical report. Like everything else in my re-treatment, what a night and day difference from my Kaiser report.  SO much detail.  I know Dr. Karas mentioned to me post op that he had to abandon the split ramus osteotomy he wanted to do and go for the normal BSSO along the same jaw cuts that were already there.  I kind of never knew why though, but figured it had something to do with the structure of those cuts and compromising the stability of my jaw any further.  My report says there were huge gaps where the bone didn't have a full union, so he couldn't make a separate cut and compromise things further.  Same with the top jaw.  He said my left side had little bony contact and was pretty much largely open still, and my right side had better bony contact.  Question now is, is this completely a physiological/biological response and I just naturally didn't get as much osteogensis as I should have post op, or was it more in response to how torqued and offset things were; so much so that it just didn't allow for good bony contact to heal. Who knows.  I'll have to ask in a few months at my next follow up.  Also in my notes are the words I have been desperately wanting to hear through all of this-- "Patient is class I."  I am officially class I!!!!  I had to pinch myself after reading that.  I figured I was class I after he called my bite "near perfect" last week, but it's nice seeing it in black and white as class I.  Otherwise, the notes read as good as what he's verbally said to me in each appointment.  I basically healed without incident, and for that I am incredibly grateful.  It's still so weird for me to go from a position where nothing ever went right and I was constantly in a posture to catch the other shoe when it dropped, to now settling in to feeling what a normal course of treatment feels like.  Unfortunately, it's finally happening at the end of my treatment, but oh well.  Every ounce of anxiety going through revision has been worth it.  

Otherwise in general house keeping notes- I think I can finally declare my numbness back to what it was pre-op (still permanently numb/tingly on the right half of my lower lip/chin/ lower right gums).  I do have some additional numbness in some other spots on my gums, but it seriously does not bother me at all.  I would say my swelling is about 85-90% gone.  Some days I am puffier than others.  The tenderness on my right side and upper jaw has greatly improved the last week or two.  The disc that was slipping in my right TMJ has been great the last month...but then after having my mouth cranked open for a teeth cleaning Mon and orthodontist appointment yesterday, it just crunched/slipped again real quick today for the first time in a long while.  I'll try to take it easy on it the rest of today and do some heat on it too.  Speaking of the teeth cleaning, my hygienist said my teeth and gums look the best she's seen in the last year or so, so she's putting me on a 4 month recall instead of 3.  And this is after surgery and all of the reduction in cleaning at first due to my opening.  Nice!  I finally gave in and bought a waterpik and that thing is fantastic.  Really makes a difference I guess!  So, who knows.  Maybe my next teeth cleaning will be brace free!!!

Few shots to show where teeth and swelling are settling.  I noticed my smile is starting to feel slightly less robotic and more normal.  Hopefully this is the beginning of more scar tissue settling as well as me getting used to the new positions of everything.


7 Comments
Lucian
5/25/2016 12:23:45 pm

Congratulations! And looking forward to only good news.

Reply
Ashley
5/26/2016 08:43:26 am

I hope so! :)

Reply
Traci
5/25/2016 07:06:14 pm

Hi! It looks and sounds like you are doing very well! I'm so glad! I am 11 days (as of tomorrow) away from my surgery to redo my lower jaw and feeling anxious, of course. The braces are on again...loving them. Not. I see my orthodontist next Tuesday for surgical hooks and molds and the next Monday (the 6th) is my surgery. He'll be doing the BSSRO this time. I'm having a hard time finding much good information on this form of the lower jaw surgery...seems like the BSSO is more common. Before my first bite surgery, I wasn't scared/anxious of the physical changes but this time I am. It took me 3 years to get used to my new face and now things will change again (lower jaw only) but there will still be changes. I am trying to figure out how the ramus osteotomy will change my face compared to the regular BSSO. Any ideas? I have a long, thin face...part of that whole open bite issue. I hope you get out of your braces soon! It is a yucky feeling when those teeth are wiggled...I prefer the stabilized feeling I have now with my braces on! Enjoy the beautiful spring weather! We are finally getting a little bit of sun here in MT. I have 5 talent shows, 6 days of school, grades, and a huge birthday party for my boys to get done before this surgery! Here we go...

Reply
Ashley
5/26/2016 06:26:28 am

So close to surgery!! I've been sending good vibes your way and wondering how close you were getting. RE: BSSO vs. BSRO, I think the BSRO allows the surgeon to do more with the height dimensions more vs. the other cut just sliding the jaw forward. I think the cut is further back in the ramus. I am not 100% sure on all of that though. It's something I've wanted to ask my surgeon about, but haven't bugged him with yet since it's not super priority to know or anything. Hope all goes well with your surgery! Drop me a line and let me know how you are!

Reply
Ashley
6/6/2016 06:38:09 pm

Hey, Traci! I think you're post op now. Hopefully all is well! Drop me a line when you're back up and chatting!

Reply
Traci
6/8/2016 07:36:07 pm

Hi Ashley! Yes, I'm officially post-op once again. My surgery went well and my bite is closed but of course I'll need minor tweaking to get everything right. I have felt pretty awful...a lot more pain than with my first surgery. My swelling is much more too! I guess I have super small thin bones so my surgeon put pins in through my cheeks (4). I had those last time as well. But, he also added plates and screws over the gaps. I have 6 plates and 22 screws in upper jaw, 4 pins 2 plates, and 8 screws in my lower jaw. I can barely stay awake today, have aching or throbbing that starts again within 3 hours of taking pain meds, intense swelling and bruising but I'm alive! I bruised some (yellow) with my first but now I'm black and blue down to collarbone. Crazy! How are you?

Ash
6/9/2016 08:10:22 am

Welcome to the other side...again! Sounds like things went well this time! Hoping you can get some rest and rebound quickly. All is well here. 4 months post op today. See my ortho on Tues for my next adjustment, so we'll see what he has to say!




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