splint: final take

I love my splint. It took months to be comfortable in it, and it still has problems, but it has changed my life dramatically. I have almost no jaw pain now. My range of motion is completely normal (no, not what it used to be, but completely normal).

I've been jealous for a year that so many people "forget" they had jaw surgery and move on with their lives - my painful jaw, small range of motion, constantly shifting bite, slight headaches and sore teeth were a constant reminder of the surgery I had in July of '09.

Now, there are days and days that I don't even think about the fact that I had jaw surgery. I can yawn without any pain (in fact, it feels good!), I can bite into anything I want to (though I still don't bite into anything hard, just force of habit), I wake up and my jaw is in the right place and stays there - little to no shifting. I can move my lower jaw side to side and forward/back (not as much as before, but enough to shift food around in my mouth and I don't notice the difference). I can play the clarinet for a good amount of time before I feel pressure in my joints (although, that's always been there). My flute playing is improving. I've had a total of around 5 migraines in 19 months.

I've been struggling on and off with a cold the past week or so, which makes wearing the splint difficult (since my splint is my retainer connected together, I usually need to breathe through my nose - it's difficult to breathe through my mouth) - at one point last week I spit it out in my sleep for the first time in a long time. I woke up with a dull headache and achy jaw! I even wear it when I take naps, not because I have to but because it makes it so much more comfortable.

I love my splint. It's a wee bit smelly and hard to take care of, but it's amazing. Love it, love it, LOVE it.

So finally... 19 months post surgery, I consider myself back to normal in range of motion, pain, and jaw mobility. My chin and face are still a bit numb, but it doesn't bother me in the least. I'm very pleased with my results - and very glad I went through all of that awful-ness that was jaw surgery and recovery.

orthodontist appointment

I had my first splint check-up appointment at Dr. Molen's office. He really likes how everything is looking. He shaved a few teeth, working on getting my bite to lock into place - because I had two teeth removed on the bottom he says the teeth don't line up perfectly - but that it was completely necessary to remove them for my jaw health.

Another piece of interesting information - the splint isn't for retaining my bite. He says he's not worried about the bite retaining itself or relapsing. The splint is to relieve pressure in my TMJs to stop the pain I've been having. Sure enough, it's worked! I have very little to no jaw pain anymore, and my range of motion has even improved to 2 and a half fingers!

I'm going back in May for another checkup... maybe that will be my last one?

splint: take three

I was supposed to have an orthodontist appointment today, but I am far too sick to venture out to Auburn so I postponed it a few weeks. I am ready to see him, as I'm still a bit concerned about my bite.

My jaw hurts much less - I have very few spasms of pain anymore like I was having. It still hurts to open wide (and I'm still at just barely over 2 fingers) and if I play the clarinet for longer than an hour or two it gets pretty sore. The worry is that my bite rarely lines up. I'm often bumping front teeth and I can't pull my lower jaw back without TERRIBLE pain. The bite wanders around all the time, though - it's very inconsistent.

Attached are pictures I took this evening of the splint and it in - keep in mind that I'm super-duper sick and look a bit freaky. Ah, well.

dentist: crown, part 1

I'm fairly surprised I don't have an all-encompassing fear of the dentist by now. It seems every time I go something goes wrong and I'm stuck with my poor, inept jaw open for long periods of time, resulting in lots of pain.

Yesterday was no surprise - I went in to have two fillings replaced, as they were placed by a terrible dentist in my teens and were showing signs of infection underneath. Those went fairly painlessly - and now they're tooth-colored fillings, instead of shiny silver! Hooray! And all of that work took less than an hour - right on track (my dental assistant is an amazing woman who knows exactly how to treat my idiotic jaw).

Then... the crown prep. I was under the impression (excuse the pun) that it was only an impression - and I would come back in two weeks for the fitting. My dentist is placing a crown on the tooth that had to have a root canal shortly after jaw surgery - my very most rear tooth in the back upper right, of course the most difficult tooth to work on with limited jaw opening.

I'm not exactly sure what went 'wrong' - something wasn't done during or after the root canal, possibly because I was in such incredible pain and it was taking too long? Whatever the case, Dr. Nuttall dug around and took off the silver and shaped and smoothed and cut a bunch of gum tissue and... 2 hours later it was over. He was quite proud of whatever it was he accomplished in there, but I was seeing spots from pain.

The good thing that came from all of this? Dr. Nuttal, being the amazing dentist he is, took time to let my jaw rest during the treatment. He tried to cold-spray my jaw, which doesn't really help me. He then started a full neck massage - which, lo and behold, really helped! After 20 minutes of massage, I felt like I could open my jaw further and it hurt much less! Could it be possible that some of my ROM problems are stemming from muscular problems in my neck? I think I'll go to my acupuncturist to find out. I'm still really interested in a physiotherapist, as well, but am not sure how to find one.

The bad thing, of course, is insane jaw pain and a tooth-ache/gum-ache/face-ache that rivals post-jaw surgery. But without all of the cool painkillers.

Much love to all the recently post-surgery folks. It'll get better - I promise!

surgeon update

Saw Dr. Lee today and we had a nice visit. She says my bite is fine (actually, she said it looks amazing and awesome). She reminded me about the jaw angle thing - that I'm at a HUGE risk for TMJ problems, along with the relapse thing. She'd like me to talk to Dr. Molen about getting a splint for at night - something that will keep my teeth apart and therefore relax my jaw a little bit. She says that the worst/hardest position for my jaw is clenched, so I need to make sure to watch that - and make sure I'm not clenching or grinding at night (I don't think I am, but since my husband is out of the state for a year I have no idea! I'll ask him when I go down to visit next month).

My favorite tech was the one to take the final pictures today and she didn't even recognize me/ realize it was me until she brought up the before pictures. She started crying - no joke - when we compared the pictures, especially the profile. I had (have) AMAZING results. I got a copy of my profile comparison (and then accidently folded it up without thinking) but will scan that in and show you guys soon.

So... She's bummed but not concerned about my jaw pain, and I'm now opening to 40mm which she says is fine. She'd like it a bit bigger but she expected me to lose ROM because of my unhealthy joints. I don't have to do physical therapy exercises - I should just eat and yawn and do everything normally (and not avoid chewing because that will make it worse), and it should continue to improve a little. I can heat and ice to get rid of some pain. I'm supposed to avoid very chewy and tough things, as they'll aggravate my jaw pain.

She doesn't want to do the injections in my jaw, but if the pain becomes unbearable (what IS unbearable, though) or if it's still around in a year, I'm supposed to give her a call... but I can call whenever I'd like, of course.

The best part about the appointment, other than hearing that my bite was okay? Seeing post-op jaw surgery patients and people getting their molds and stuff done. Had a nice conversation with a gentleman about ready to get upper jaw surgery. Almost exactly a year ago I was in that office, doing the exact same thing!

shifting

Things aren't really looking so hot for my bite, currently. On Friday I had my first migraine since surgery, and I noticed my bite felt really off. It's been feeling a bit off since I got my braces off, but that's because my bite is settling (and that's a good thing, I'm told).

Well, on Friday afternoon I noticed my bottom front teeth were bumping into my top built-in retainer. It kept happening and kept happening and my jaw was starting to get the shooting, awful pains from right after jaw surgery so I called Dr. Molen's office today and they got me in - Dr. Rick thinks my bite is just settling into a natural position. He thinks the headache and jaw pain were caused by my front teeth bumping the retainer (and therefore not being able to close naturally).

He tried to sand down my retainer so it wouldn't bump anymore, but ended up just taking it out. I go in next Wednesday and he'll re-check everything and I think I'll get new retainers, since now mine are a tiny bit loose since the built-in is gone.

Tomorrow I see Dr. Lee for my final pictures and x-rays, hopefully she'll have some insight on my small range of motion and all this stupid jaw pain.

Overall, though, I'm still glad I had the surgery. I ate corn on the cob tonight for the first time and I was able to eat it neatly and cleanly, 2 rows at a time. Only 1 migraine in a year is just fine with me - and that migraine went away once I took a pain pill and slept through the night - it didn't make me puke until I had to go to the ER or anything.

updates

I'm still around, trying to find time to make a big de-bracing entry. A few observations:

• Not having braces is AWESOME!
• Flossing and brushing takes just a few minutes even with the built-in retainers on top and bottom.
• Retainers get smelly really easily. Yuck.
• While my orthodontist said I could only wear my retainers at night, I've found that if I wait all day (on days that I play instruments, anyway) I have to squeeze on my retainers and it's painful.
• My ROM has improved slightly - prior to getting them off two fingers fit in tight, now on good days they even have a little space.

Stressful things:

• My bite doesn't always line up, especially after playing clarinet/sax. The overbite is not a lot bigger, but I'm going to call Dr. Molen as soon as I have a free afternoon so he can double check it. Because it's definitely shifted a bit.
• My jaw still hurts a lot. Bummer. Once school is out I'll see Dr. Lee and we'll think about doing something about it.
  

sigh [part 2,862]

Sigh.

Braces? Still on.

Bands? New configuration, and now the side ones on 22 hours a day and the front ones at night.

Jaw? No end in sight to this blasted joint pain. On one hand I really don't want to bother Dr. Lee because she's said TWICE now that there's nothing she can do until the bands are off, but on the other hand I don't know how much longer I can go around in pain like this without going crazy. Off the deep end crazy.

Sigh.

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 :)

monthly panic attack, check

It seems it's time for the monthly "this-is-totally-never-going-to-heal-I'll-be-a-freak-my-entire-life" freak out. Please, fellow post-jaw surgery friends, answer me one or more of the following:

1) How long after surgery did you have to do physical therapy - and what was that physical therapy? I'm doing the stupid tongue depressor stack-of-hell, the awful squash ball between the back teeth, and the push the lower jaw to one side or the other and hold.
2) How is your range of motion now, and what was it like 4.5-ish months post op?
3) Can you move your lower jaw side to side? What about forward and backwards? When were you able to start doing this?

It feels like I'm going nowhere with this physical therapy, and it's beginning to wear on me. It feels like I'm doing it all for nothing, as nothing is improving except for maybe my tolerance for pain. I'm back to icing again, perhaps will try heating before the therapy stuff.

What are my other options? I've called my surgeon. She says to do the exercises more, but I'm doing them all I can.

At a bit of a breaking point here...

everything's fine, of course

Except my range of motion... I'm only at 29mm and they want me at 48. That's practically half of what I need to be. Ouch...

The pain in my right jaw joint? She thinks it's inflammation from the tight rubber bands and struggling against them to talk all day (teacher!). The pain/weird clicky feelings behind my front teeth? My bones growing and I'm able to feel the plate now.

If it all continues? I can get a shot of steriods in my jaw for the pain, and if the plate is still really bothering me I can get it removed a year after surgery.

Blah. I figured it was normal, but it was good to hear.

I am not an orthodontist

A few things on this fine freezing evening.

Fondue was AWESOME! I could eat almost everything (and did). What a nice anniversary (I still can't believe we've been married for 5 years...)

I got my nasty green bands changed for the conference this weekend... and then promptly had the opportunity to eat palak paneer again (the dastardly green spinich/cheese indian dish that did me in to begin with). Well, instead of getting the rubber bands green OR skipping one of my favorite dishes, I just took the rubber bands off. It hurt. I had my doubts that the rubber bands were actually doing something, as I don't have gaps up there... but within 10 minutes of having them out I was scrambling to put them back in. I have to remember, I am not an orthodontist.

I have a back tooth that is quickly tipping on it's side. I have been telling myself to not worry about it (after all, I'm not an orthodontist) and to stop being that patient... but who am I kidding? I AM that patient. I'm calling on Monday when I get back from conference. I'd rather be annoying and lame than have my surgery postponed because of one rotated molar.

All the new metal and rubber inside of my face is intensely annoying. My front teeth have somehow shifted, causing me to spend an entire rehearsal thinking my clarinet was crooked and possibly put together wrong. My gaps are closing with a quickness, but causing me to have the bite from HELL. I have migraines most days. I can no longer eat a meal without brushing directly afterwards (the little metal criss-crosses are A+ grade food traps.

I am ready for surgery, already...

rubber bands

I learned a new lesson. All of that yummy, soft indian food that Nick brought home to comfort me with the major metal mouth was great... but it turned my new rubber bands GREEN. Very bright green. And while normally I wouldn't mind (neither my kids at school nor my husband really cares), I have my annual music education conference in less than a week and just wearing braces is bad enough, let alone wearing braces and stuff that's all nasty looking.

My jaw is intensely sore. I really need to go back into the acupuncturist. It's cramping up like crazy, and sending spasms of pain into my neck. But since it's Friday, I came home early and am able to take my stronger muscle relaxant. Hopefully it'll help.

It's Nicks and my 5th anniversary this weekend, and we're going to a fondue restaurant. It will either be fantastic and easy to eat or terrible and I won't be able to eat anything. Hopefully the former, not the latter.

migraine part 1,000,938,822

I'm beginning to believe that every time I have an orthodontist adjustment, I should just prepare lesson plans for the next day so I don't have to worry about it the morning of. That's right, I'm home with a migraine AGAIN.


The only bright side is that I have an amazing husband who brought home two giant bags of indian food (all slow-cooked and delicious and mushy and doesn't need to be chewed). So I just had an amazing meal that I didn't have to chew once.

I am ready to be done.

half marathon + surgery?

I'm not sure what's happening... but I got a doozy of a migraine on Sunday and it hasn't left, missed yet another day of work on Monday. Today I spent the day wearing earplugs which resulted in mildly offended middle schoolers. (Not fun. Not fun).

My jaw is also intensely tired... but I haven't been working it out, I swear! I have stuck to my rigid chew-as-little-as-possible regimen, eating oatmeal and soup and smoothies instead of "real" food. It is spasming left and right, and I can not find a comfortable resting position to save my life.

On another note, I've been considering running a half marathon for a while now and my friend wants to do the Seattle Rock and Roll Half Marathon with me... however, it's June 27th. School is already going to be delayed getting out by at least two days (we've had a bit of snow this December in Western WA) which places us out of school on the 19th. If I had my perfect date, I would choose June 29th for a surgery date.... but I'm wondering about putting my body through the stress of a half marathon only to have major surgery two days later. What do you guys think?

doctor visit

I had an intake appointment yesterday and had a long conversation about my jaw pain and headaches with my new primary care physician. She has decided to prescribe me the same muscle relaxants for the next 7 months until my jaw surgery. She is worried about my body adjusting to the medication and addiction, but we both decided that those risks were smaller than dealing with the long, intense migraines of the past few months. I guess I'll deal with the addiction bit once I get past the surgery....

I have REALLY noticed a difference now that I'm on muscle relaxants and doing acupuncture... I have less jaw pain than before, especially while playing my clarinet. I have only had three migraines in the two weeks since getting started on them, and each of those migraines lasted less than a day. I am able to get through my 5th period class without being in considerable pain (it is my last period of the day, and usually the most painful).

Good news.

I hate to get ahead of myself....

... but my jaw was not especially sore today, nor did I have a headache! Usually Tuesdays are my worst days for jaw pain and headaches due to my 2 hour rehearsals on my clarinet on Monday nights.

The funny thing now? I don't know what is actually giving me relief. I didn't play as much as usual last night (nightmares of migraines), I am trying acupuncture, I have those new muscle relaxers AND new day-time pain medications (sodium naproxen).

Still, I have a glimmer of hope [again]. Hopefully it's not a fluke this time.

acupuncture and adjustment

Acupuncture was this past Friday. I had needles. In my FACE (and neck, shoulders, hands, and feet). It was a bit scary. The acupuncturist was very good - he made me feel very relaxed, asked me a lot of questions, told me he thought acupuncture would help (and he can also fix my I'm-suddenly-getting-old-or-something weird stuff going on like my hip being weird). The needles stung a little bit going in on my face, but nothing more than a pinch and a sting and it was over. He left Nick and I in a nice warm room to hang out for maybe 20-25 minutes with the needles in (good picture time). I didn't feel any immediate relief, which was a bummer because I was coming off of a doozy of a migraine, but the next day I woke up to no pain. Not even a little. In fact, I didn't really notice anything was different until I went to yawn and I winced and grabbed for my jaw joints like I usually do and realized it didn't hurt. It didn't last long, maybe an hour, but I now have confidence that it can work. He says that the relief will be more immediate and more long lasting as treatment progresses.

Then the next day I got the worst migraine I've had in a long time. Hopefully not connected... I still have it now and I'm contemplating missing school tomorrow it hurts so bad.

Adjustment was today. They x-rayed my teeth and took off a maybe 7-8 brackets on my lowers and 1 on my uppers for replacement. She put the same wire back in and I was originally disappointed (no pain no gain!) but immediately I felt the results.... and 8 hours later my teeth are singing Wagner. Whoo-eee! I was sad, he made a comment on my teeth getting a little discolored. I drink coffee. I LOVE coffee. I'm not sure how I'm going to give coffee up, but he's right. My teeth aren't as lovely as they once were. Any ideas?

Oh, and progress pictures. The gums keep swelling (the splints make it worse, I think), the overbite keeps growing, and the gaps keep closing. On and on.

acupuncture, part two

I didn't realize that I had a mandatory district laptop training on Monday (my district is giving me a laptop to use though! Hurray!).... and the next appointment open is on Friday. So a week from today, I'll know about the acupuncture. While I'm scared out of my wits about it (I really don't like needles), it seems like a last resort - I mean, what else can I do? I don't see very many options.

The past few weeks I was wondering what was going on with my splints - it seemed as if they weren't working as well, and I was wondering if my jaw had perhaps adjusted somehow to them.

Well, I fell asleep during a movie last night and didn't put my splint in - and I would rate my jaw pain today at an 8. Edging higher and higher as the day progresses. Luckily it was an inservice day, not a teaching day - but I went out to lunch with my staff, ordered a bowl of tortilla soup and only was able to drink the broth. Thank God I didn't have to teach - I mean, I can't really talk.

Hey, but it's probably for the best - now I can't eat any of the yummy Halloween candy sitting in a bowl by my front door. Heh.

Happy Halloween, everyone!