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.

hopes up

Sad as it might be, the night before every orthodontist appointment I think "Ooh, maybe my teeth are so perfect now he'll take the braces of tomorrow!"

...................

Now, in the real world I know my teeth aren't perfect yet (or even close enough to take the darned things off). My two upper front teeth are different heights and still look a bit crooked, and while my bite is finally meeting in all of the places it's supposed to (my back AND front teeth touch at the same time!) I always meet first on my right side and after a school day where I don't wear my rubber bands I have to shift my bite around to get all of the teeth to meet.

In my dream world, though, these puppies are coming OFF! Hopefully the rubber bands WILL be finally coming off, though(6.5 months later, aye!). I'm going to wheedle and deal and whine and beg - I want to see if the jaw crap really is from the bands, and if not, I want to fix it (and, uh, now).

Much love to all the braces buddies out there. Miss you guys! Someday soon I'll join you in falling off the face of the earth, though! Can't wait!

bone graft kiddos...

I forgot to post this last time, but I went in for my yearly physical last week and my doctor and I talked a lot about my surgery. When she noticed the scar on my hip I told her about the bone graft and she asked if I had been massaging the incision site. Apparently once the incision site is healed it should be deeply massaged twice a day for the year following the surgery - it will prevent too much scar tissue from forming and improve the muscular function, range of motion, and tissue health/ healing - even though my surgery was 6 months ago it's still healing.

So I started to massage it twice a day and sure enough, it's definitely still healing in there - very tender when I dig my fingers in and massage. I'm already feeling looser in that hip when I run - I've been struggling a little bit as I get my mileage back up I feel like my gait is a bit uneven coming from my right hip.

So, if you have a bone graft from anywhere but your mouth - good to know! :)

sensation

This week I've had a lot of sensation coming back into my chin. The slight downside currently is that sensation coming back equals a constant 'itching' feeling all over my chin - no matter what I do, it doesn't make it go away at all - I find myself scratching it all the time. But in the long run, wahoo! Feeling! More feeling! It's slow, but 6 months out I'm still seeing major improvements.

6 months out. Crazy. I've been damning the jaw pain and eating what I feel like - I ate an almond, steak, salad, and crispy chips and crackers galore. I also realized that I only chew on the right side of my mouth, and I'm wondering if that's contributing to my lack of range of motion side to side - I can force my jaw a millimeter or two to the right, but not at ALL to the left. So I'm trying to chew with my left side only when I remember.

Quick pity-poo-party: It seems like EVERYONE is either out of braces or about to be out of braces. 6 months (or more?) seems like SO. STINKING. LONG.

Okay, it's over. Wahoo, no migraines STILL! 6 months!

Happy New Year!

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.

thankful

For all you Americans out there, Happy Thanksgiving! It's funny, this year I am thankful for an odd thing.

I haven't said anything on here, but I've been a little discouraged again about the face. I'm still not quite used to it, and it's been pretty swollen between the root canal and new rubber bands and a minor sinus infection - which I'm sure hasn't helped the matter. However, today after running I decided to take the extra 15 minutes and blowdry my hair - after it was done, I realized that I really like my new face today. The new haircut accentuates my new jawline and new chin and it really is flattering. Maybe I should dry my hair more often :) So, I'm thankful for becoming used to my face.

I haven't posted a picture for a while, and I'm not sure it's even really changing much anymore, but here you go - along with pictures of the new rubberband configuration at my orthodontist appointment this past Tuesday. He told me that the reason for my root canal was a cavity that had become irritated, and there was really no way for it to become painful due to the shortening of the roots (phew!). They changed both of my wires out, gave me lots of new hooks again, added the metal lacing between the front brackets on top and bottom again, added some rubber tie-backs from my incisors to the back teeth to close those gaps again, kept me in my old rubber band configuration and added new crazy ones up front. I'm allowed to take them out while I'm teaching now to help aid with my jaw pain in the right joint, but he wants me to try to hit 18 hours a day, and then 24 (minus eating and brushing) on weekends and any breaks. Luckily, my next appointment is a month earlier than it normally would be - in mid January. Hurray!

Also, with the jaw pain/ lack of range of motion, the heated rice sock has continued to decrease my jaw pain. For the first time since surgery (edging on 5 months now) I can yawn without severe pain. Whenever I'd accidently yawn fully my right joint would SCREAM. Now, no pain! I'm not sure if it's the rice that has done it or if it's because my ROM has increased (still at 20 sticks) and now yawning doesn't strain the joint, but I'll take it.

new love

I officially have a new love in my life - the rice sock I made to assist me in my physical therapy exercises. It's just a bunch of jasmine rice stuffed and tied into one of my husband's mammoth socks and microwaved until the point of explosion (okay, slight exaggeration). When placed next to my sensitive and painful right jaw joint prior to and during physical therapy exercises, they don't seem so terrible. In fact, I got up to 20 tongue depressors! Now, to ice the rest of the pain away. I also pre-medicated with ibuprofen a half hour before the exercises.

I'm going to try to focus on the positive once again. Tuesday I see my orthodontist and I'll have a long conversation with Dr. Molen about this stuff to see what he thinks.

I won't break, I'm just stressed. I guess I shouldn't be comparing myself and my jaw and my healing to everyone else. It doesn't help anything. I WILL try acupuncture (don't know why I didn't think of it myself... thanks, Kate) and I'll keep this heating and icing and medicating bit going and, well, it'll all work out in the end.

I'm still glad I had this surgery - despite the pain in my jaw that lasts and lasts, it is still better than daily migraines. I have a beautiful occlusion - my lower teeth sit right behind my upper teeth! I'm struggling with this slow healing process (unable to chew many foods still, no jaw movement side-to-side or front-to-back, limited range of motion, and pain in my left TMJ), but I think I should just relax...

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...

emergency dentist appointment

I would love for all of this drama with my mouth to be over.

As my teeth and gums are beginning to have feeling again, I noticed my back tooth on my upper left side has been especially sensitive. I've been ignoring it, as I figured it was all in the course of getting feeling back (just like my chin used to burn and have those weird shooting pains). Well... two weeks or so later, it's just getting worse and worse to the point of being unable to chew on that side so I called my dentist yesterday. They had me come in today (which worked out well because I was dropping the husband off at the airport for another round of military training)...

Two hours, four x-rays, 3 dentists opinions, and a lot of testing later they decided I needed to see an endodontist (which I had never even heard of) TODAY for my rear-most teeth on the top left. I drove straight to the endodontic office where they decided they were doing an emergency root canal - or, really, half of one. They cut open the tooth and pulled out all of the insides and stuck a cap over the top. They'll finish the root canal on December 28th.

It turns out that my roots are so shortened on those upper two teeth that it may have caused all of the sensitivity and pain. Since I can't feel the tooth in front of it, they think I might have to get another root canal on that tooth - since it's in the same boat. It sounded like I could have lost the tooth the roots were so short, and they're not even sure the tooth is completely viable.

Since I have such a limited opening, that was a terribly painful set of appointments. The endodontist prescribed me valium and percocet for the next appointment - I'm supposed to take one valium an hour before the appointment, and then another one a half hour before the appointment. I can also take a percocet. My jaw on the right side is now popping in a new way - almost like bone or cartliage rubbing against bone or cartliage, and it is INTENSE.

The GOOD thing about the appointment, though, was the numbing shots didn't hurt at ALL because I still have limited feeling in my gums/ upper palate. Whoo hoo!

I know this shouldn't upset me so much, but I spent the entire 35 minute drive from my dentist to my endodontist sobbing. Granted, part of that was the lack of sleep last night (helping Nick pack) and then my husband leaving for over a month during the holidays... but I'm pretty down about all of this. I am SO done with everything to do with my mouth.

funny stuff

Part 1: You guys will like this story. I was checking out in Target tonight and I got the funniest cashier EVER. He rings up my purchases, asks me how I'm doing (the normal) I smiled at him and said "Oh, doing fine." He LIGHTS UP when he sees my braces and says "Whoa! Braces! How long do you have to wear those things?!" I'm a little bit thrown off now, and respond with "Oh, about 6 more months or so." "Whoa! Like, were your teeth like THIS?!?" And he literally puts his hands in an L shape - like my upper teeth were so crooked they were parallel with the floor (yes, floor). I said "Ummm, no, not quite that bad. But pretty crooked." He then goes on to tell me ALL ABOUT his wisdom teeth and how he wants braces... Seriously? Odd.

Part 2: I get hit on a LOT more now that I have a chin.

That's all.

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.

back to the surgeon...

I'm heading in for an emergency appointment with my surgeon tomorrow. The nagging, sharp, and almost constant pain the right jaw joint combined with the weird random swelling combined with the weird painful click-y feeling behind my front teeth/nose meant missing a day of work to drive back to Seattle. Poor band/orchestra students. Yet again, I'm missing too much school!

Now, I don't want to complain too much - but I had no idea I'd be 4 months out and still dealing with all of this. I'm still doing physical therapy - up to 19 sticks now. It's still yucky and painful. I still have problem with many foods - no steak yet, no salad yet (I can't chew it well enough and swallowing lettuce whole is unpleasant, to say the least), nothing crunchy, I have to be careful with breads, nothing chewy... Am still unable to bite into things 'cause the jaw doesn't open wide enough...

The numbness is still around but I truthfully barely notice it anymore. I have SOME feeling everywhere, some places are just a little more tingly or slow to respond than others.

I don't know anyone else with this problem, but I think the weirdest thing for me has been playing instruments again. With a correct occlusion I'm a much better flute and trumpet player, but my low brass and clarinet (boo) skills have gone out the WINDOW! With low brass I'm double buzzing all over the place and can't keep a pitch center... with the clarinet I sound terrible and leak air like a sieve. I can't figure out a good angle, and everything is different. Yuckity yuckity yuck.

this will seem funny later, I'm sure

I got my yearly benefits open enrollment package last week at school. My school district is changing to the state union benefits! The benefits I had when my braces journey first started in my first school district, the amazing benefits that would have paid for my surgery no questions asked.

Just a year too late. Argh. Instead, I have a 51,000 dollar bill still attached to my name.