Thursday, August 5, 2010

FAQs

I get a few questions quite often, so I decided to link some of my more "eventful" entries down the side of my page, but also wanted to answer a few questions here. If you have more, I'm happy to answer them.

What kind of surgery did you have? I had upper and lower jaw surgery plus surgery to extend my chin (genioplasty). My upper jaw was shortened, moved forward, and leveled out. My lower jaw was moved forwards. I also had a bone graft from my right hip to reinforce my upper jaw.

How long did it take you to recover? I still feel like I'm recovering a bit over a year out of surgery, but for the most part I was feeling much better after 6 weeks. I went back to work at my part-time job, Starbucks, at 5 weeks and while it was fine, I was really tired. If I worked an office job or any job with less talking/standing/moving, it would have been easier. I started teaching full time around 8 weeks after surgery, and that was also a bit difficult in regards to getting enough food and having enough energy.

Were you numb after surgery? Do you still have any lasting numbness? Yep. I was completely numb after surgery (Pretty much no feeling from my eyeballs downward, except for a few patches). Over the past year, much of the feeling has returned, but I am left with numbness in my chin, upper lip, and some areas of my teeth and gums. None of it bothers me, except for when the nerves work overtime in my chin - then it kind of itches and drives me nuts - but that means it's healing!

How did you get your insurance to pay for surgery? If you look back from September 2009 to May 2010, you'll find all of my insurance trouble. My insurance company had a orthognathic surgery exclusion - no matter what, medically necessary or not, they would not cover the surgery. I was lucky enough to be able to appeal to my school district with letters from my surgeon, orthodontist, and myself, plus my migraine diary and ER reports, plus X-rays and diagnosis from my surgeon. They ended up paying for it in full.

Are you happy with your results? Overall, yes. Prior to surgery I was suffering from almost daily migraines, constant headaches, and terrible jaw pain. Since July 1, 2009 I've had 2 migraine headaches - 1 just days after surgery from a major muscle spasm, the other just a few months ago. Both went away with medication and sleep, rather than hanging on for weeks at a time.

I still struggle with some aspects of my jaw - for instance, my range of motion/ jaw opening is now stuck at 40mm - when prior to surgery it was almost 60mm. It is very difficult and painful for me to hold my jaw open for long periods of time (think dentist or orthodontist). I can't eat a lot of very hard or sticky foods. I am pretty much unable to move my jaw from side to side or forward/backwards - which may or may not improve.

Looks wise, I am also happy with my results. It's taken a long time to get used to my new face - and while I still look like "me" I'm quite different. By shortening my midface around 10mm everything from the position of my ears to my nose to my cheekbones and eye sockets changed. It's pretty drastic. It took months and months for me to get used to the new face, but now I love it.

What kind of braces did you have? How long were you in braces? I was in braced in Damon (self-litigating) braces for around 2.5 years. This time, anyway. When I was younger, I had conventional braces and headgear twice, trying to correct my overbite and crowded teeth.

How are you retained? I have clear plastic retainers that look like Invisalign. In a few weeks I'll be getting a Damon Splint to help relax my jaw and hold my teeth at the same time.

Did you use Zip 'n' Squeeze bags or the Cool Jaw Wrap? No, I didn't use the ZnS bags or their wrap - I was fortunate enough to order from them when they were still a functioning company, but I despised the ZnS bags - I ordered around 20 and only used 1 (but they have already been given to another lucky jaw surgery patient months ago). I was much happier with toddler sippy cups and the large gauge syringes from my surgeon. As for the jaw bra, I bought a jaw hot and cold wrap but the hospital ones were much more effective - and they gave me 3 or 4.

Were you banded or wired shut? I was banded shut for the first week, and then could take off the bands for a few hours a day to eat and brush. I was then on a mush diet for the next 7 weeks - anything I could swallow whole or mush with my tongue was fair game.

What did you eat? You'd be surprised what you can eat despite not being able to chew. The first week, being banded shut, I was stuck with broth-based or cream-based soups with no chunks, juices, muscle milk, Isopure (fruit flavored, clear protein drink - great for the first few no-particle days), and Gatorade. After that first week, almost anything is possible with a blender and some sort of liquid - chicken broth, milk, or juice. If you crave it, go for it! :) I went for pizza at one point, and it was pretty awesome. Everything does look a little like cat food, though...

You're a musician. How did this process get in the way of playing wind instruments? I'm a clarinet player. Braces alone were pretty wretched for clarinet playing - I had to re-learn to play as my teeth moved and straightened. Once jaw surgery happened, I was unable to play any wind or high string instrument for 3 months - and this was pushing it, per my surgeon. If I didn't teach beginning band and orchestra I think she would have had me wait longer. My embouchure was radically changed, and I had to re-learn to play. Everything from the angle of my horn to how my corners sealed to how my tongue is placed in my mouth changed - and it was pretty difficult and frustrating. I ended up taking a few lessons which really helped me. Now, a year later, I play more in tune with a better sound and have a better range - so it's worth it in the end.

What was the bone graft like? I think the bone graft was the worst part of the surgery. It made walking really difficult, made wearing stiff pants difficult, made showering difficult... pretty much awful. It was far more painful than my jaw, possibly because of the cut nerves.

How long did you have to wait to exercise after surgery? Because I had a bone graft out of my hip, I had to wait a few months to start running again. I was supposed to be walking right out of surgery (the next day), and was encouraged to exercise/walk as I saw fit, as long as I wasn't in pain or overdoing it. I also had weight-lifting restrictions for the first 6 weeks.

Did you have problems breathing after surgery? Yep, had breathing problems. My swelling was pretty darn intense which closed one of my nostrils and my nose was clogged from the, well, blood and stuff. Things that helped: Steamy showers (I just sat in the bathroom with the doors closed and heat on since showering was difficult after the bone graft). Humidifier - heck yes, get one. When it was off, I was much more congested. Q-tips soaked in hydrogen peroxide: Gross, but very helpful in removing debris. Afrin: Now, it says only to take it every 12 hours or something, but right about the 9 hour mark I would start getting panicky and suffocated. If I were going through this again, I would ask my surgeon if I could use it a little more often. Saline spray: This helped clear some of the gunk out. Overall, if I just concentrated on breathing "breathe in... breathe out..." I realized I was getting enough air. No fun, though - especially at night. This only lasted from around day 2-5.

Did you get sick after surgery? No! I was very concerned about this, and talked about it with my surgeon and anesthesiologist. They gave me lots of anti-nausea drugs and they all worked!

How bad was the swelling? Did it last very long? Oof, swelling. My swelling peaked at day 5 (you should check it out: it's FAN.TAS.TIC). The swelling was mostly gone - i.e I could go in public with no funny looks at all - after a month. I was still swollen in my mind, and people that knew me well could tell I was swollen, but it looked normal to everyone else. By the 2 month mark I was almost completely back to normal, despite obsessing over it for a lot longer than those 2 months.

How did you exercise your jaw post-surgery? Now, make sure to ask your jaw surgeon prior to trying any of these... but I used Popsicle sticks (the big ones... tongue depressors?) for one exercise - fitting as many as I could in my jaw, and holding it for 30-60 seconds at a time. I also had to push my lower jaw using my hands from side to side. I also used a squash ball - think a ping-pong ball but squishy - and squished it down, put it between my back teeth, and let it expand.

How bad is jaw surgery (really)? Truthfully, looking back and reading my entries I know it was terrible. But a year later, I don't remember much about it - in fact, the whole month of July 2009 is a bit hazy (probably all the Demerol and lack of a sleeping schedule). I'm really glad I did it. So, know that a year after surgery you'll think it "wasn't THAT bad." *Smile*

Those are all the questions I can think of getting the most often... If you have more questions you can email me at stephanierae2804 at yahoo OR you can message me on facebook (use the link on the sidebar) OR you can leave it any comments and I'll get back to you.

8 comments:

Brent said...

Hi Stephanie!
This is really helpful! I was reading the "new on the block" last night and bam it appeared. Just for a point of clarity for me, did the insurance company finally pay for the surgery or did the school district? I think I mis-read your thread of posts a while back..
What say you?
Brent

stephanie said...

My school district did. There were ways to appeal through my insurance company despite it being a contract exclusion, but my school district ended up paying for it (phew!).

Autumn said...

Really glad you posted this. I'm actually looking in to having something similar to what you had. Except opposite. Wonderful results! :)

naomi said...

Steph, where are you located? I am having similar problems... my oral surgeon now is backing down because of something another oral surgeon said to him. Whereas before he said simply, "I won't say migraines will necessarily get better with the surgery," now he's saying, "I don't think you're a good candidate for surgery."

I want to know if maybe I can see your doctors, or maybe they can recommend someone to me. I am in Boston. Thanks!

stephanie said...

Naomi - I'm in Tacoma, WA (pretty much as far from you as you can get!). My orthodontist and surgeon were VERY careful to say that they had no idea if surgery would actually fix my migraines. My orthodontist went as far as to say he said it was a really good chance...

Get a second opinion. I would NOT have gone through jaw surgery if I wasn't a sure candidate for it due to my overbite - my teeth would have worn down completely and my TMJs would have degenerated completely - so even though I wasn't sure it would fix migraines, it would fix SOMETHING. It's insane surgery. Close to 2 years later I'm still not fully recovered - but it's worth it.

I had no ideas where my migraines were coming from. I had them pretty bad before braces, and braces REALLY aggravated them to the point of insanity - because prior to braces I kind of had a class I bite due to how crooked my teeth were - once my teeth shifted my overbite really appeared.

Let me know if I can help you any more!

Melanie White said...

I know what you mean on not having a sleeping schedule. I have been up for about 3 hours now and it's almost 3am. Other than that I sleep most of the time...I just want to eat and be up for more than a few hours lol

Anonymous said...

many years ago I had braces and headgear..but i must have it again,teeth sliding over each other.
But i like it,all luck on my headhear...fun.

Chris Armeno said...

I just came across your blog! Thanks for answering some of my questions! I am having surgery on June 17th and am stoked! I am also a clarinet player (a performance major at that) and I am terrified after reading your answer about that. I am only having the upper jaw done and am curious as to whether or not I would be able to play sooner than 3 months!! If I'm not able to play for that long I might have to take a semester off, which would suck! haha Any tips or suggestions on playing after surgery would be great! Thanks, Chris :]