jaw surgeon visit, part billion

Went back to the jaw surgeon last Tuesday. Nothing happened - she seemed surprised I was in rubber bands, told me she didn't want to do any injections into my jaw joint (a combination of steroids, anti-inflammatories, fluid, and pain medication) until I was out of the rubber bands, because it's a bit major and it won't do anything if I'm still banded. She gave me a prescription for vicoden and told me to come back in - in a month - if it was the same (and I was out of rubber bands). The injection will take anesthesia - laughing gas type - and it can be done in her office.

I didn't even fill the prescription. I'm concerned about taking too many pain-killers like vicoden and percocet - high addiction profiles. PLUS, I really feel that those types of pain killers are for pain that I can't handle. And I can handle this pain, it just sucks. And wakes me up a lot at night.

I immediately called my orthodontist, but they were already out for the holidays. My joint pain is still wretched. I still have no side-to-side or forward-to-back motion in my jaw (less than 1mm change in either direction is possible, even when I push as hard as I can). My ROM is pretty much exactly the same, 28mm this time (but I'm sure I could have stretched it to the 29 I got last time). Nothing is improving, and she seems to think it's all because of the rubber bands so I guess I'm trusting her.

We talked about why this is happening - the angle of my lower jaw is quite extreme - in 'ideal' jaws it's close to parallel to the floor, mine is a very steep angle from the lower jaw joint to the chin. This means my muscles are too short, and pull sharply over the joints - which causes a high risk for relapse (yay not me!) and TMJ pain/ problems. My joints ARE remodeling, but she's not concerned at this point. Hopefully this will all resolve itself once the bands are off. I'll talk to my orthodontist about it at my appointment on Jan 19th... My bite is almost perfect when the rubber bands are in, but when I leave them out for a few hours (I only have to wear them 18 hrs a day) I can tell it becomes off... my right side doesn't even touch after a few hours.

Anyway, I don't mean to be a downer around the holidays. Even with all of these problems I'm having, I'm really glad I went through the surgery. I am still migraine free, close to 6 months after surgery. My bite is perfect with the rubber bands! And things are improving... I ate fruit and nut bread from a good friend, I am starting to be able to eat without thinking - in moderation, crunchy and chewy things are possible now.

first cleaning post-surgery

I survived! Luckily, this time I got a much more gentle dental hygienist this time, who went very slowly and carefully around all of the metal and rubber and blech. I'm still missing a lot of feeling in my gums and teeth, but where I CAN feel is hyper-sensitive to anything and everything. Between that and my jaw opening MAYBE halfway, I was intensely nervous going in for the appointment today.

I haven't actually been in for a cleaning since June of 2008 - right about then the insane migraines started when propping my jaw open for long periods of time, and I chose to wait it out. I figured I'd be able to have one soon after surgery, making it only a year between cleanings, but I'm almost 6 months post-op.

However, despite having braces, having jaw surgery, AND not getting a cleaning for a year and a half, my teeth looked pretty good! She said I had deposits around the normal areas where the saliva glands are (on the back teeth and the front teeth, apparently?), but overall looked very good. I really work hard with the waterpik, floss, little brushes, and my sonicare to get everything nice and clean.

I have some receding gum stuff going on in the rear of my teeth - ironic, really, since I have so much puffy, extra gum up front from irritation from the rubber bands and being a mouth breather (though, much less of a mouth breather since surgery!). You'd think my body could just... well... even it out, right?

My jaw is pretty sore, and I'll end up taking a painkiller for it so I can sleep tonight - the pain is by far the worst when I'm sleeping anyway, and the few nights after my root canal I was waking up every half hour or hour. I'm calling my surgeon tomorrow to see if they're in the office and I can drop off the insurance payment and talk about that pesky right jaw joint.

Let me tell you, I can't stop running my tongue over my teeth now! They feel so wonderful and smooth :)

good news

I have so much good news!

• My insurance company is finally paying up! Swedish hospital credited my account all of the money I've had to pay (phew!)
• My root canal was a piece of cake today, tooth wise. Jaw wise it's a bit of another story, but it was SO much easier than last time thanks to the valium and pain killers BEFORE the work started.
• Dr. West (the endodontist) said my mouth opening was considerably larger this time!

I get a cleaning next Monday, the first one in over a year. I didn't go before jaw surgery because of the massive migraines (any dental work or orthodontist work put me into the ER, if you don't remember)... and then I've had such a limited range of motion I haven't gone in. I know they won't be able to get everything - I've got ten pounds of extra tin and rubber in there not including my braces AND my my range of motion is still pretty awful- but at least it'll be a start and I can go back again in a few months once my ROM gets better. I'll let you guys know how it goes.

aha!

It was a fun weekend of visiting good friends from college - ones I haven't seen since surgery, which always makes me a tad nervous. In regards to my face, I think my friend Chels said it best - she said that I look "really different, but then I smile and laugh and then I look the same."

I realized, my pictures aren't really my real smile - my real smile is BIG and shows lots of teeth and metal and my face crinkles up, and my laugh makes the huge smile even BIGGER. I love to smile and laugh, and love that now I'm not really self-conscious about it - I mean, no more centimeter of gum showing! Here are the best pictures that I can find of my real smile (two before braces - then with braces before surgery - then after surgery) which can't be replicated well in one of my "look at my progress" pictures.

(I hope no one IN these pictures minds me posting them on the internet. If you do, let me know and I'll photoshop you out!)

why I teach middle school

I LOVE middle schoolers. They say the funniest things.

This girl in one of my last classes at the end of a very long day says to me "So... Mrs. Sheppard" in a very serious voice.

"Yes?"

"Do you like Twilight?"

... pause... "Well, yes, I enjoyed the books. I read them. I didn't enjoy the first movie as much. Wait, why?"

"'Cause those things in your mouth make you look like a vampire."

(Cracking up inside) "Oh yeah, that's why I wear them."

Girl tilts head "REALLY!?!"

21!

I just reached 21 popsicle sticks! I have officially tripled my opening from the first physical therapy day in early August. I'm sitting here the dreaded squash ball in my mouth, drooling all over as I type this... but I was so excited I didn't want to wait to tell everyone. 21! 21! 21!

Life is good. At the very least, life could be much worse.

appointments

Lots of dental/mouth appointments during winter break this year - on the first Monday of break I'm sneaking in for a cleaning - I have so much metal/ rubber on my teeth I'm not sure what they'll be able to accomplish, but at least they can start chipping away some of the grime (ew!). I hate the feeling of my teeth ever since surgery - I just can't get them clean! And I know they were concerned about buildup especially in the rear of my mouth where I still struggle to clean - I floss, but I'm not sure I'm getting everything because I can't open my mouth wide enough to see inside of there, and I also don't have much feeling back there yet. I'm a bit worried about having my mouth open - but it seems it's not getting any better any time soon, so I might as well quit waiting and getting cavities :)

Also, later into break I've got the rest of my root canal appointment, which ought to be a real fantastic time - at least with that appointment comes valium and percocet (don't worry, my husband is driving me!). PLUS I'm calling my surgeon tomorrow to 1) figure out this insurance crap and 2) make an appointment to get my joint looked at again.

So... insurance stuff. I had to make a 1,000 dollar payment last week because my account was going into default. Can I just say that I have NO IDEA why they're still billing ME?! Shouldn't it all go to my district - the district that agreed to pay for my surgery? And they're being REALLY SLOW with the purse strings apparently, so I've got to make payments until then. And, well, we don't exactly have thousands of dollars laying around. Augh, to say the least.

I have a good feeling about physical therapy this week - I feel like I might get to 21 popsicle sticks! The last two nights 20 hasn't been excruciating. I think that doing the exercises 3 times a day instead of 2 times is improving things, too - it seems like the therapy exercises aren't such a 'shock' to my jaw when I do them more often (my sessions in the morning and afternoon are shorter than my evening session). And the heat, again, REALLY helps. I ice only after my evening marathon session. I didn't do as much as I should have over the weekend (I'm stressed to the max and didn't even think about it - I even forgot to brush my teeth one night, I fell asleep in my chair with my laptop on my lap!) and my jaw was hurting pretty badly by yesterday - but with three sessions of therapy we're back!

Since I'm in blogging mode - let's do a full update. Since the new rubberbands up front my teeth are meeting almost perfectly - I ate salad tonight without too much trouble! Sometimes my teeth on the right side hit before the left, but I'm sure that will work itself out.

Numbness - Like I mentioned before, many of my teeth/ upper gums are pretty numb still. I have feeling, it's just slow. My chin is coming back like crazy this month - it itches for no reason, tickles, when I brush my fingers over the skin it tingles - whoo hoo! My lips are almost back completely. (bummer, as a clarinet player). I guess my cheeks still have some numb spots. The weird thing is, is I don't even notice the numbness anymore unless I test for it. It used to bother me - kind of felt like wax was dried on my skin all the time. But now I don't really notice it.

I think that's it! Minus the ROM and possibly displaced disk on the right side, things are good. And I have faith that things will get better after a long talk with Dr. Lee. Goodnight, everyone!

thank you, fish sticks

Since surgery, there are a lot of foods I just can't quite stand any longer. Ensure, Muscle Milk, and Slim Fast all make me gag even thinking about drinking them. I'm not in the mood for any kind of tomato soup, smoothies, even ice cream and frozen yougurt isn't all that appealing any more. I don't enjoy Gatorade as much, either.

In the weeks following surgery once I was cleared for soft foods (if you remember) I "ate" a lot of fish sticks and potato wedges (er, mashed them up with a lot of tarter sauce and swallowed them whole). It was one of my favorite meals for probably a month. Well, like everything else, I became tired of fish sticks.

Tonight I was in the Metropolitan Market where they sell my tasty fish sticks (not the cheap, nasty ones - they're actually real fish!)... and lo and behold, I kind of felt like eating them!

And you know what? I can eat them now! We're talking, pick up the fish stick in the hand, dip it in the sauce, and take a big bite - and then CHEW them! It was pure heaven. The entire time I was thinking about those first few weeks of eating solid food and how terrible everything was.

Despite all of my continued painful and long healing process, I really have come a long way. What a nice reminder. Thank you, fish sticks.