Getting over an underbite

blogging my way through double jaw surgery

Archive for the month “January, 2014”

7 Weeks

snowMy follow-up visit for today was cancelled. 😦 I’m sure due to the weather. Ice and snow everywhere around here. I am NOT looking forward to driving to work today. This kind of conditions freak me out driving.

So… I was going to show off to him how I can my mouth open 33 mm. That is after stretching it out. After being banded all night I can only open 27 mm. But it’s getting there.

I feel like I spend so much of my life brushing my teeth these days. In the end I wonder how many months of my life will I have spent doing this? I was not a fanatic before braces, but well now after surgery I brush at least three times a day. I’m a bit more of a stickler these days with mouth health.

Here’s my status at 7 weeks:

  • Energy levels: Back to pre-surgery normal.
  • Strength levels: I’m a weakling. Not sure when I’ve ever been such a wimp.
  • Swelling/stiffness: Upper jaw is still pretty stiff. Just a little swelling still on each side of my mouth.
  • Eating: I keep trying more things. I can’t chew per se, but I can bite straight down and lightly crunch things.
  • Pain: My teeth are sore 24/7 from wearing the bands at night. It makes it near impossible to bite anything. And I really want to try my new bite!
  • Jaw Muscles: I have discovered that I can feel these tight muscles on the inside of my mouth. I’m strung like harp strings and feels very strange. It’s so tight that on one side I still can’t floss a wisdom tooth. Just not enough give to stretch the cheek out and get floss back in there.
  • Flossing: I can floss all the other teeth, though with the wisdom teeth, it can take me five minutes to get one tooth flossed. Whew. So tight and crowded in the back of my mouth due to the tight muscles mentioned, and swollen cheeks.

Finally, here’s a comparison photo (where I am actually wearing the same sweater). The first is the week I got braces on, the second is yesterday. It’s still crazy to me when I look at before and after side by side.  And yes I do need a hair trim. Getting one soon.

Week 7

Count the Cost

The reason I finally got the surgery at my age is that I finally found a way to get the cost of surgery covered. I mentioned I had tried once in college; the surgeon refused to even do an initial consult since I didn’t have insurance. I tried again when I worked at a big university in my 20s. I was participating in a research study on my teeth, and the surgeons were dying to fix my mouth. They could not convince my insurance at the time that was anything more than cosmetic.

ImageFast forward a number of years and I move out to try again. I get braces on again and our insurance covered $1250 of the cost (lifetime max). We paid the rest out of pocket. I paid for my workup out of pocket (forget the exact cost now). Which brings me to the surgery. I’m sharing my insurance statements for surgery to show what a crazy insurance/medical system we have going on. It rather amazes me.

So here it is:

What the doctors and hospital charged my insurance company:

  • Overnight Hospital Stay: $865
  • Anesthesiologist: $2,625
  • Hospital Charges: $43,780
  • Physician Charges: $14,985

What the insurance allowed as charges:

  • Overnight Hospital Stay: $254
  • Anesthesiologist: $1,913
  • Hospital Charges: $6,261
  • Physician Charges: $3,719

So here’s the summary. The hospital/doctors charged the insurance $62,255. The insurance allowed $12,147 as cost. Per my plan I only have to pay 10% which is $1,214. !! Back when we though the insurance would deny the surgery last year, I asked what the charge would be to us out of pocket. We were quoted ~$22,000.  I can’t even figure how they got that number. It only goes to show that if you have to pay a medical cost out of pocket, you should definitely try to bargain them down.

The entire surgery cost me less than the braces. !! I’m feeling super blessed it all worked out.
Happy smiley
Quick update on my status these days:

Change is not as frequent, so I won’t be posting as frequently now. I’m up to opening my mouth 25 mm. I’m happy about that but have to get it open another 5+ mm by Wednesday. I managed to eat at a potluck last night, mostly pasta and creamed corn, but glad there were things I could eat. Everything else is continuing as usual, with tiny improvements. I’ll post again next week after my next doctor visit and my first orthodontist visit post-surgery.

6 Weeks

Hard to believe I am now typing that I am six weeks post surgery! It has been a long six weeks. The last few days I have been feeling pretty good about improvements, then woke up with more swelling than I’ve had in over a week. So yep, trudging along with recovery.

I read so much in preparation for this. So many things have been just like I read in many other people’s experiences. Yet you do not know what it is like until you go through it. For example, I heard you won’t be able to open your mouth much after surgery. But I didn’t know how that would feel, stretching my mouth past the pain point multiple times a day. What it would be like to crumble my food up, shove it in on the ends of my fork and hope the whole bite makes it in. What it’s like to try chewing but it does absolutely no good. I didn’t know if it would take days or weeks to get full range back.

So, the good things about being at 6 weeks:

The swelling is going down enough that I start to think I may be close to how I’m supposed to look. It’s down enough I can smile without pain, just pressure. Down enough that I can use a straw a little better, drink from a cup a little better, and form my words a little easier. I can sing again. I can lean over up to 90 degrees, for just a few seconds longer.

The further I stretch my mouth, the easier it is to eat! 🙂 I stretch before meals and brushing and those tasks are easier. Sunday I sat down and had dinner with my husband, same food as him for the first time since surgery. I am trying to practice chewing occasionally, though it doesn’t do that much good yet. But thought I’d better at least keep trying.

My lower jaw is behaving and staying where it needs to be now. While I am still conscious about it some of the time, for the most part is is good and nestles right where it should be. All the work to make it learn its new native spot on my face is paying off. It’s still some strain, but better than before.

The strange feeling in my head/ears after I got debanded was gone after about 5 days. The doctor said that may have been from swelling in the eustachian tubes that has now gone down.

Somewhere along the way I can now fall asleep without background noise or light. The first weeks, no matter how tired I was, I could not fall asleep without music or the TV in the background to lull me off. It’s just in the last week I can turn the TV off and sleep in the dark and quiet all night.Day 34

My numbness is receding. It’s happening so gradually I have just recently noticed this. Looking at the picture here, the numb area is barely the triangle that is formed by my cheek lines and upper lip. Even that is starting to fade a little. (Inside my mouth my gums are still completely numb, however.)

A couple weird things:

My my jaw hurts mostly on one side when I stretch it. The tightness seems very lopsided to me but the doctor said this was normal.

That my teeth hurt like I’ve had a big ortho adjustment. This apparently is from the bands that I wear overnight. Another reason I wouldn’t be able to chew right now.

 

And….I actually tried pepperoni. It was a no-go even cut up tiny. Ah well, I’ll keep on with the soft foods for a while.

Day 38 – Week 5

Now that I’ve passed 5 weeks and taken my bands out, and much of the swelling has gone down, I’d say from outside appearances I am looking mostly recovered to other people (not that I am going to take a poll on if I seem normal). But I feel far from healed.

On opening my mouth up (necessary for such things as eating and brushing teeth):

The doctor said yesterday I was not opening up wide enough. I was feeling semi-pleased with my progress before the check-up. At yesterday’s appointment I could open 18 mm. Before surgery I think I could open about 49mm, to give you a comparison. The doctor would like me to be opening past 30 mm by my next appointment in about two weeks. He gave me some exercises to do multiple times a day. Now not only am I practicing open and shut, but also side to side and forwards. I won’t deny it, these stretches are PAINFUL and leave my jaw sore afterwards. After doing them, I feel so flexible. Only to find the next time I do them it seems I am back where I was.

On training my jaw to stay put:

I mainly have to wear the two bands overnight now, and a little during the day. That definitely making it easier to practice opening, and for talking as well. But the point of the bands is to keep training my jaw where it is supposed to stay. I am doing a lot better at keeping my jaw in place even without the bands. However it does not feel natural to me it. I have constant jaw strain from this; I think it will take a while before it feels normal.

How does my face feel anyway?

My face does not feel right yet by a long shot! If I pay attention, the lower jaw feels shrunken and pushed back, and my upper jaw feels huge and stiff. My teeth feel like they have an overbite, although to be honest I think they are fitting together perfectly. None of this feels natural or normal, and when I look in mirror, it does not look natural or normal yet either. Thought it’s not that obvious, I still have some swelling in the face, evidenced by the pressure when I use my facial muscles. And just maybe (haven’t scientifically determined this yet) the pressure increases greatly when we get cold fronts. Or I guess it could be doing this randomly. Who knows.

How’s eating going these days:

Well, slowly. I can use a small fork (at home, privately) with plenty of napkins and plenty of time. I can also use baby spoons. I’m still drinking some of my meals; I just don’t have to thin them down anymore, which does make things easier. I can manage any food that’s small and is already ground up, or soft enough to squish around and swallow. Some types of things I can eat: scrambled eggs, baked fish, rice pasta, polenta, oatmeal, applesauce, sliced cheese. I don’t think I will attempt small grain things like rice & quinoa for a while; just too hard to clean afterwards.

On what keeps improving:

I’m just happy it’s much easier to clean my teeth! After de-splinting I quit using the prescription mouthwash; it’s back to regular now. I thought about continuing, but it says long term use can stain your teeth. I can floss most of my teeth with patience. (Flossing the back is painful since I can’t open far, and the wisdom teeth? impossible).

The pressure is slowly decreasing. Less pressure when leaning over (not that I do it much). Less pressure when smiling.

I’m slowly regaining energy. Still tired most of the time, but every week is better than the one before, and every week I can do a little more. Also I am dreaming dreams again. I notice I feel more rested when I have normal dreams (which granted for me are pretty weird). So I guess I’m sleeping better. Last week was my first full work week. I was pretty exhausted and a little overwhelmed. This week I managed a little better.

Here’s a pic showing how much I can open. I tried to add some emotion to the pic but not sure of the result.

wide open

And one normal one just so that’s not the only picture in this post.

day 38 from the side

Day 35

It’s been a few days since I’ve been un-banded. It brings a new freedom and a new set of problems.

The first day I could open my teeth about one finger width. The doctor said he wanted to see me open wider at the next visit. That’s in two days. After about 5-10 minutes of working at it, I can usually open a few mm wider. So I have learned to do this BEFORE eating and it makes the meals a little easier. After 4 days the sharpest of pain is gone when opening wide. It’s been like someone taking a butter knife and twisting it in my cheek (left side) when I try to push open. Now it’s down to a dull pain on both sides, but the more I do it the better it is. Problem is I have to put the two bands back on, and my mouth is closed again for a few hours. Then it’s back where it was and I have to stretch it out all over again. Slow progress.

So today I thought I would also talk about Things That Have Been Helpful To Me In Recovery. bottle

Condiment bottles- bought these on clearance at the end of summer. I used the ones pictured for cold things, and had a different one for hot things. Starting using these once the syringes got overused and impossible to use.

Notepad & pen- I bought a whiteboard and markers for after surgery, then realized last minute that unless I had an eraser too, it would not be helpful. So I took a notebook and pen and nearly filled the notebook with notes. I carried it with me everywhere for the first week and half. By two weeks I was talking well enough completely on my own.

Lots of pillows – especially for when I was sleeping in the bed. Now that I’m in the recliner, I still use two pillows at night to help keep my head where it needs to be.

Baby monitor system- During recovery I am sleeping in the basement apartment. It has just worked out better this way for different reasons. We got a monitoring system where I play the part of the baby and my husband has two units for when he is upstairs. He is able to hear instantly if I call out or had trouble with anything, and can talk back to me as well. It has proved very helpful especially during the early weeks.

Texting plan – When I couldn’t talk much, we also I texted a lot when were on different floors. Just easier to communicate.Image

Folding mirror – helpful for learning to eat all over again. Used it from day 1 and am back to using it again with a fork. Also helpful for remember what you look like again.

Kleenex – I have gone through a small mountain of tissue boxes. I keep a box in every room and in the car.

Qtips – also went through loads of these, especially at first. For the nose.

Chapstick – I go through chapstick like crazy, even these days. Banded, it’s impossible to keep your lips moist. Even now, they barely touch, and I still have to slather on chapstick regularly.

Loose comfy clothing – clothes that were easy to pull on and off (no tight necks or shoelaces for me!)

Mindless entertainment to pass the time – I have to say, I was not up to reading much at first. It was hard to concentrate much, and sometimes the swelling near the eyes would make them hurt. I had other projects that I could have fiddled with as well, but didn’t have the energy. I ended up watching a lot of movies, etc. and later after I could handle it, lots of food shows.

Nice notes from people – Yes it’s encouraging to hear from your friends and family even/especially when you can’t talk to them! It’s so nice to get texts, messages, get well cards etc. Keep this in mind when you know people going through a recovery process. I appreciated so many people’s thoughtfulness and knowing people were thinking of me and praying for me.

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