Chat with my orthodontist

The orthodontists (I work with a father/daughter team) wanted me to come in for an X-ray today. Apparently the surgery wasn't as certain in their minds, because it's happened rather rapidly. If they had their druthers, it probably wouldn't happen for another six months, but since the timing works very well for us, and they don't see any contraindications, they said, "Let's go for it!" Their basic conclusion after looking at me today is, "We think it will work. Let's see what the surgeon says at the pre-surgery appointment." Way to inspire confidence! :-) The pre-surgery meeting is October 15th.

Chat with my family doctor

Yesterday I had a chat with my family doctor, one of the topics being preparing and recovering from the surgery. He doesn't want me to do anything differently leading up to the surgery as far as supplements go (I'm taking a general multivitamin). I'm already doing pretty well on nutrition, so it's just a matter of eating well in terms of fruits and veggies and having a good diet in general.

I have a problem with seasonal depression, and most people have a depressive crash a couple weeks after this surgery. The stress of a liquid diet, the trauma of surgery, and the pace of recovery just send people into a bad spot. Every year I try to go without medication for as long as possible, and this year I had high hopes that I could make it with a very improved diet and other measures. But the doctor thinks it would be best if I just started medication a week before surgery (if I don't end up starting before that because of my symptoms), to prep for the post-surgery crash. I'm still going to be doing measures like supplementing vitamin D and having a very strong natural light lamp.

After the surgery the doctor would like me to supplement extra vitamin C, and continue with as good a diet as I can.

Pictures

Front, not smiling, not trying to hold my lips together (ie, natural position).

Front, smiling. Gummy smile.

Left profile.

Right profile.

Teeth close-up, showing open bite (I could not get them closer together than this).

Some terms defined

In my last post I posted the letter my surgeon wrote to my insurance company. It used a lot of medical-ese terms that I'm going to define and clarify here.

mandibular - lower jaw

maxillary - upper jaw

hyperplasia - overgrowth

Class III dentoskeletal deformity - This basically means that my jaw grew wrong such that I'm left with an underbite--my bottom jaw is too far forward.

maxillary vertical hyperplasia - This is the 'gummy' smile previously mentioned. This also means, "cannot create a lip seal without mentalis strain"--ie, my lips don't close unless I work on doing it, so they are almost always open.

maxillary transverse deficiency - This means my upper jaw is too narrow for my lower jaw. I can attest to this one because if my teeth are together I can feel the bottom of my upper tee

th with my tongue--they stick out into my mouth.

mandibular sagittal hyperplasia - This means my bottom jaw is too far forward.

osteotomy - A surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment.

LeFort I osteotomy - Le Fort was a surgeon who pioneered these surgeries. The LeFort I surgery is a horizontal cut in the bone along the top jaw. See the pretty graphic of a skull for a visual.

mandibular osteotomy setback - This basically means they are going to cut out a chunk of my bottom jaw and move the front part backwards.

Reasons Why

I am going through with this surgery in the hope that it will improve several quality-of-life issues that I have. There is no guarantee on many of these, but 'a significant chance' for most of them. Things that I hope will improve:

• headaches - I have a lot more headaches than your average person. They may be due to my muscles being tense because of my jaw not being in the right place.
• breathing - I cannot breathe out of my nose very easily. It feels like I'm breathing through a very long, thin tube if I try.
• chewing - I chew in very limited places in my mouth because I don't have all that many teeth which touch.
• cleaning - Things like flossing have been challenging because of teeth crowding and placement.
• tooth destruction - The improper placement of my jaws is leading to my teeth being destroyed. There is pressure being placed on the teeth that shouldn't be there, and already this year I lost one tooth because of it. Other teeth would follow one at a time if this were not corrected.
• aesthetics - This is last of all because I didn't/don't really think I have a problem with my appearance. I didn't like having crooked teeth, but the braces could have fixed that if it were the only issue. After talking with the surgeon I'm aware now of my 'gummy' smile that is a sign of what's wrong with my jaw, but if that were the only issue I would NOT be going through with this.

This is part of the letter that the surgeon wrote to the insurance company. I hadn't realized how bad off I was until I read this letter! It's funny how dire my case sounds when you put it in the medical-ese. It's also interesting to me that I should have an improvement in my ability to speak, according to the surgeon. I've always sounded very nasal-y. I wonder if that's going to improve! Also sometimes I feel like I don't speak very clearly, but I always attributed that to being sloppy and lazy with my mouth. It would be interesting if that would improve, as well.

Misty is a 30-year old female presenting with a Class III dentoskeletal deformity. Of note she presents with maxillary vertical hyperplasia 524.01, maxillary transverse deficiency 524.03 and mandibular sagittal hyperplasia 524.02. These medical diagnoses when combined create a significant anterior open bite and dentoskeletal deformity. They cannot be corrected without surgical intervention.

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A multiple piece LeFort I osteotomy.... This will be combined with a mandibular osteotomy setback.

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Misty has no esthetic complaints and is seeking the jaw surgery to allow a stable dentoskeletal relationship. She will have a decided improvement in her ability to chew, speak and breathe following surgery....

Jaw surgery

Good morning!

I'm writing this blog because I will be undergoing double jaw surgery at the end of October (the 26th, to be precise), under six weeks from now. It's a major event in my life, and it's taking a lot of mental processing power to prepare for everything. Writing a blog will help me process it, and it will also help those who are going to go through the same thing. I know I've been helped tremendously by the blogs of those who have undergone this surgery.

There is at least one thing that is different about me that I haven't read about in the jaw surgery blogs yet, so maybe I can add to the collective experience and tips. I am still nursing my youngest baby, who will be almost 16 months at the time of the surgery. I also have an almost four-year-old daughter, and a baby (who is taking a bottle) who will be 14 months at the time of the surgery. We live with my in-laws, and my mother-in-law watches the kids during the day, so it isn't going to be as stressful as it could be having three young children post-surgery. But still I can imagine there will be some challenges associated with this situation.

Later today I'll post details on the procedure I'll be having, as well as why I'm going through with this surgical jawnt.

Yours,

Misty

PS: I know it's a horrible pun, but I had to do it.