23 Days Away!

I had my pre-surgery appointment at the University of Pittsburgh Dental School today with Dr. Ochs and his Chief Resident, Dr. Parker. Neil went with me again, (Thanks for lending me Neil again Katie!) which was great because any time I didn't have an answer to something I just looked at Neil. The appointment took about 2 hours. It started with the paper work describing the surgery and everything that could possibly go wrong. That was fun. Then I met with Dr. Parker and he explained the surgery to me, shaved down one of my upper canines so that it would fit in place after the surgery, took measurements of my bite, two sets of alginate impressions, a wax bite impression, and a plastic bite impression.

Next we took the "before" surgery photos of my mouth and front and side profile. Then Dr. Parker put these dots (see photo below) on my face for the CBCT scan. He put the wax mold back in my mouth and I had to sit very still for 50 seconds while the machine worked it's magic.

I think the CBCT scan is the coolest part of this process. With the CBCT scan they are able to make a 3D rendering of my skull. They then do digital versions of the surgery to practice the movements of the jaws and find the best alignment for function and aesthetics. A copy of the scan is sent out to a company that 3D prints the jaw bones so that they are able to bend the brackets that will hold everything in place prior to the surgery. Amazing!

Dr. Ochs came back in at the end of the appointment to answer questions and look things over. I was lost in dental jargon here, but he checked my bite, said a lot of fancy things, handed me a mirror and asked how I felt about the way my upper jaw looked. I was confused because I wasn't sure what he was after but basically where he was going with it was that he may NOT have to do the upper jaw. He said they will do two surgery plans: one for both jaws, and one for just the lower jaw. If it looks like the movement to the upper jaw won't be very significant then he will just bring the lower jaw forward. He said he doesn't like putting his patients through more pain if the end result isn't significant. He was happy with the work my Orthodontist had done since he was able to bring my front teeth down and create a good arch. Prior to braces my overjet was 11 mm which is pretty big. I think it's 7mm now if I remember right. 

When he first saw me he thought I would definitely need both jaws re-aligned since it was so severe. I've mentally prepared for having both jaws done but if we can just do one I'll be ecstatic! The LeFort 1 osteotomy is pretty invasive. They have to cut into your sinus region and you can't blow your nose for a long time or you can cause a bad bleed.  The recovery is a lot slower for double jaw surgery too. My friend just had a similar surgery involving the lower jaw and not the upper and is doing great! She is my hero right now! :) 

I should know in a week or two what plan they decide on. I'm fine with either, but will be praying for just the  lower jaw (BSSO-Bilateral Sagittal Split Osteotomy) so I can be back on my feet sooner. Cross your fingers for me! Thanks for reading!

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We have a date!

After a week of frequent voicemail checking and a lot pacing, the Patient Coordinator for Dr. Ochs finally called and set the date for surgery! June 22nd! It's just far enough away that I'm not a hot mess but close enough that I know it's a real thing now. Exactly a year ago this week I had my initial consult in Pittsburgh. I remember leaving the hospital feeling very overwhelmed and mortified. I'm happy to report I no longer feel overwhelmed or mortified (but still anxious). On a scale of Jaw Surgery to SCUBA diving, I would much rather have this surgery done than attempt SCUBA again! 

I'll be getting another call either tomorrow or in two weeks to schedule the pre-op visit to take x-rays, molds, and the 3D Cone Beam CT to prepare for surgery. They'll actually use the 3D model to do a digital version of the surgery, as well as make all of the plates and screws that will fit almost perfectly to my jaw bones. Isn't technology cool?!

I have some questions that I want to ask when I get a chance, but it probably won't be until this visit. 

Will I be banded shut? I've read blogs from some awesome ladies that went to the same Doctor as me and they were not banded shut. At my initial visit he said I would likely have to be banded shut. 

How long is the recovery? I know I can expect to be off work 2-3 weeks and it takes 6 weeks for the bones to set, but when I will I feel like a normal human being again? When can I go to the gym again? Lift heavy things? Go to boxing class? etc. I read in other blogs and articles that full recovery is 6-12 months. AHH! 

What kind of food can I have? Will I be able to breathe? What if I throw up? Will I regain feeling in my face? How much pain am I going to be in?... Just to name a few a more!

In the mean time, I've started on my shopping list. I've purchased Ensure for taste testing purposes and so far so good. I need to review some other blogs to come up with the rest of the items to purchase. I also need to come up with a list of everything to do before June 22nd since I think summer 2015 is going to be a bust physically. I will miss 6 AM boxing classes the most (believe it or not Rob!). I wanted to run a Spartan Race this October and there's a good chance I won't be physically capable by then, so I could potentially run the May race in Ohio now. I've heard that I can expect to lose 18% of my body weight and unfortunately a lot of the muscle mass I've gained over the last year. That is probably the most depressing part since I worked so hard to get back in shape. So realistically, running a grueling race in October is out of the question, and I probably can't go back to boxing until November or December. I'll cross that bridge when I get there though! For now, I'm just happy to have an actual date. 

Stay tuned! 

Now, we wait.

Good news! I had my 11 month check up with my Orthodontist this afternoon and we took impressions to send to Dr. Ochs. Once he looks them over I'll know when surgery can be scheduled. He could still get them and say more adjustments need to be made, but I hope everything is good so we can set a date. The hardest part has been the wait, since I can't make any plans for this summer until I know the date of the surgery. Every time someone asks I just tell them that it's "sometime between April and June 30th." As exciting as all of this was, the highlight of my day was when they tightened a hook that had come loose and had been jabbing my lip at inconvenient times. I woke up at 3 AM this morning disoriented and in pain to realize the hook had turned and caught on my lip despite my attempts to cover it in wax. FUN!

In preparation for the main event, I have started to test out some juice and shake recipes. So far the winner for juices is Joe Cross's Mean Green. The best protein shake I've had is Drew Manning's Spinach Shake.  Soon I will venture into testing soups and ensure/boost flavors since that will also be a big part of my diet for 6 weeks. The idea is that if I'm used to some of these things it won't be too much of an adjustment when the time comes, but that's  probably easier said than done. I'm sure at some point I'll try to blend pizza out of desperation. Maybe even birthday cake.

I should hear back from the surgeon in April and can proceed from there. In the mean time, below are some Netflix suggestions if you're feeling brave like I thought I was. The result is that I now spend twice the amount of  time in the grocery store reading labels and eat a lot less processed food. It was life changing!

My video list:
Fat Sick and Nearly Dead
GMO OMG
Forks over Knives
Vegucated

Currently reading:
On The Shortness of  Life by Seneca
In Defense of Food by Michael Pollan

January Check Up

I went for my 4 week adjustment today. My Ortho said we're getting close to being able to take impressions and send them back to Dr. Ochs. There's about a 2 mm gap between my left canine and pre-molar and a 1 mm gap on the right side. He said we need to get the left side to 1 mm as well and then he thinks we can schedule surgery. So for the next 4 weeks I get to wear this fun elastic set up to try to bring the back teeth forward and close the gaps.

In other news, I bought myself a Ninja Pro yesterday! I used it this morning and I love it! We have a Nutribullet at home and it's fantastic. I went with the Ninja since it had a little bit of a higher rating and stronger engine.

And.... My family got me this awesome juicer for Christmas and I love it as well! I 'm taking a dual approach to trying to stay healthy and get the nutrients I need while in recovery. It's also a lot of fun to juice things. Whole apples disintegrated in less that 3 seconds! So much fun, and it's healthy!

It's Getting Real

Let me start by wishing everyone a Happy New Year! Now that it's 2015, and my surgery is approaching I figured it was time to get serious about my jaw surgery blog. When deciding whether or not to have Orthognathic surgery I read a lot of other great blogs that helped ease my concerns. It also seems like a good way to pass the time while not being able to do anything for a few weeks.  Let me explain a little bit about what I'm having done and why:

I have what is called a Class II Malocclusion (retrognathism): Meaning that I have a severe overbite and the upper teeth and jaw significantly overlap the lower jaw and teeth. This causes a host of problems, the first being that it's hard to bite or chew anything. I have never been able to bite through pizza or a sandwich with my front teeth. Before braces, my lower jaw actually touched the roof of my mouth instead of the back of my teeth so it was painful to even try to bite normally. I would have to use my premolars to tear through food, but most of the time I just cut everything up. The misalignment also causes TMJ, breathing and swallowing issues, and a weak side profile.

I learned all of this information at my first Orthodontic appointment in early February of 2014. I knew I had a bad overjet (see photo below) which is why I finally decided to get braces, but wasn't fully aware of how severe things were. My Orthodontist did a great job of explaining my options to me. The first option being braces with no surgery to align the teeth the best he could, but my bite wouldn't be fixed. He was also concerned with how far he would have to move the front teeth to try to make them functional and the root damage that could cause. Option 2 was double jaw surgery to align the jaw properly which in combination with braces, would give the best overall functionality and look. He referred me to Dr. Ochs, who he felt was one of the best surgeons in the country at this type of surgery. I agreed to at least go to the consultation to see what he said.

I had my consultation with Dr. Och's at Pitt School of Dental Medicine in April. My friend Neil who is a student at Pitt Dental, agreed to come along with me and help translate dental speak. Dr. Ochs and his staff were great and explained things very well. He showed me on a skull where the cuts would be made and how the jaw would be repositioned and put back together with plates and screws. I would be having a Lefort I Osteotomy and a Mandibular Osteotomy.  It would be roughly a six hour surgery, I'd spend one night in the hospital, and I'd be banded shut for around six weeks. It would be a liquid and soft food diet for six weeks, and six months to a full recovery. He explained the risks of nerve damage, and that most people don't have serious damage but some people have a quarter sized spot of numbness in the lower lip area.

Now here comes the kicker - If I wanted the surgery done through Pitt Dental it would have to be done by December due to Highmark Blue Cross and UPMC insurance issues. At the time, I didn't even have my braces on yet so the braces would have to go on ASAP and wisdom teeth had to come out in MAY! It was going to be cutting it close since it usually takes a years worth of adjustments to prepare for surgery. I had roughly a week to make the decision, then I had to call back and schedule the wisdom teeth removal. I took the whole week to make the decision after talking to several friends who have undergone the same surgery, as well as my best friends Katie & Neil, and Neil's dad who is also an Oral Surgeon. I talked it over with my family who was concerned, but supported my decision to have the procedure done.

I had my wisdom teeth out in May which went well. I also got to practice the liquid and soft food diet for about a week and a half. I got my top braces on 10 days after the wisdom teeth came out, and the bottom braces on in June. After what I feel is nothing short of a miracle, Highmark and UPMC reached some kind extended agreement so I was able to have my surgery pushed back to 2015. I have my next Orthodontic appointment on Monday and will find out how much closer I am to being able to schedule the surgery.

(Day after Wisdom teeth removal)

Thanks for your interest in my jaw surgery saga, and I hope to be able to keep it updated on a regular basis. I won't make every post this long, I just had a lot to cover!