Tuesday, October 14, 2014

Various pre-op appointments - only days to go!

Over the last month I've had a number of appointments in preparation for my surgery which is now just a couple of days away - so here's a quick update.

On September 17th (one month prior to surgery) I had a pre-op appointment with my maxillofacial surgeon.  It was quite a lengthy appointment which I was glad of as it gave me a chance to ask lots of questions and generally be put at ease.  We discussed the surgical plan and what he hopes to achieve before he took some moulds/impressions (to make the surgical models and splints), 360 degree x-rays and plenty of photographs.  He also took various measurements of my jaw and profile and explained what I should expect during my stay in hospital - which will involve waking up from surgery with a gastric tube and (I'm cringing while writing this) a catheter.  Eek!

A couple of days later I had a telephone call from my anaesthesiologist who introduced himself and had a chat with me about how they would be taking care of me.  He again re-iterated that I will have a gastric tube and a catheter when I wake up from surgery.  The thought of a gastric tube didn't actually bother me until just now as I have realised what it actually is.  I thought it was a tube which goes down the throat to the stomach to deliver food.  Nope.  It is a tube which is inserted through the abdomen and into the stomach.  For some reason that bothers me a lot more than a tube down the throat.  Of course all I need to do to forget the gastric tube is think of the catheter.  Double eek!

Then on October 10th I had a pre-admission appointment at the Prince of Wales Private Hospital where they took my blood pressure, did an ECG, took some blood (in case I need a transfusion) and gave me information about the big day.  On October 16th I will be checking into the hospital at 6am and can expect my surgery to start around 8am.  As it is a 5-6 hour surgery, it will be the only one my surgeon performs that day.  Then after a night in intensive care, I will be transferred to a ward where I will most likely stay for 2-3 days.

Finally today I had a pre-op check with my orthodontist who also placed several surgical hooks into my mouth.  These are small metal hooks which are crimped around the wire of my braces.  They are used during surgery to help my surgeon move my jaw around once the bone has been cut.  In the photo below you can see one of them between my front teeth.

So that's it!  No more appointments now, just a count-down to the main event.  I must admit that I am feeling very excited, scared, positive and apprehensive all at the same time.  While I'm not too concerned about the surgery or the pain, I am nervous about the end result and hope that after all of this time and effort I will finally be happy with what I see in the mirror.

And on that very deep note I shall finish this post and will write another update soon.

Sunday, August 24, 2014

I feel very special - thank you Cindi

This is a short post but it still deserves a blog post all of its own.  My friend Cindi is flying out all the way from California to spend the first two weeks with me after my jaw surgery.  She is coming to help take care of me and I feel very lucky to have such a great friend.   Thank you Cindi, you truly are amazing and I cannot wait to see you.  xxx

Tuesday, August 19, 2014

I have a date for my double jaw surgery!

I'm very excited to report that I am now booked in for my orthognathic (double jaw) surgery on October 16th.  This surgery will be the most major and invasive part of my treatment plan and involves a number of medical procedures.  It also means that I am nearing the end of my journey, although I will still have to wear braces for up to six months after surgery.  I'm going to throw around some medical terms here, so I will do my best to explain what everything means.

Preparation for surgery
I have a pre-op appointment in mid-September.  At this time my maxillofacial surgeon will take x-rays, moulds and from there make my splints and build the final surgical plan.  It will also give me the chance to ask lots of questions and make sure we agree on the outcomes.

The surgery
Orthognathic surgery is a very general term, the definition of which is 'surgery to correct conditions or abnormalities of the jaw and face'.  More specifically, my orthognathic surgery will involve:
  • LeFort I maxillary osteotomy (upper jaw) and Bilateral sagittal split osteotomy or BSSO (lower jaw) - That's literally quite a mouthful, but in layman's terms they will remove sections of bone from my upper jaw (maxillary) and lower jaw (mandibular).  This will take my upper jaw upwards (to remove my gummy smile) and backwards (to finish correcting my overbite) while at the same time correcting the skewed angle at which my upper jaw has grown.  My lower jaw will be split and extended forwards, creating a stronger, more balanced profile.
  • Genioplasty - also known as chin augmentation.  A surgical implant will be used to alter the shape of my chin.  This in conjunction with the double jaw surgery assists in creating a balanced profile.
  • Turbinectomy - a procedure in which some or all of the turbinate bones attached to mucous membranes in the nasal passage are removed.  This is used to relieve nasal obstruction.
  • Septoplasty - a corrective procedure to straighten the nasal septum.
At the moment it is estimated that my surgery will take around six hours to perform and will involve a three day stay in hospital with the first night being in a high-dependancy unit.  Here is a YouTube video (don't worry just an animation) which gives you an idea of what the osteotomy part of the surgery will look like:

Recovery time
I will need to spend the first couple of weeks at home resting and will have several weeks of swelling and bruising.  I'll also be on a liquid and soft food diet for at least six weeks, so hopefully I will lose a bit of weight at the same time!

So what will this mean for my face?  Well I'm not going to come out of the other end looking like Joan Rivers or a contestant from Extreme Makeover that's for sure.  And despite the suggestions of my friends, I've opted not to have a breast enlargement "because you may as well while you're there"!  What I should end up with is a squarer jaw line, no overbite, a stronger chin, a straighter septum, a balanced profile and of course teeth that all meet and a better functioning jaw.   Hopefully I will just look like a normal guy.

I must admit that while I make jokes and say that I'm fine with everything, I'm actually starting to get very nervous.  I'm not so worried about the pain or the healing as I know I can handle that, but I hope that the end results will make this whole journey worth it.  I hope that I will be able to look into the mirror and finally like what I see.

So that's my big news!  Keep posted for more updates in the lead up to my surgery.  I also plan to blog from my hospital bed so you'll be with me every step of the way!

Wednesday, July 30, 2014

My dreaded gap has finally closed!

I went for my regular adjustment appointment on Monday and as usual I had my power chains replaced.  Now I love it when I get my power chains replaced, mostly because they are fresh and white and everything looks a lot nicer.  Then, this morning when I woke (only two days later) I noticed that the gap in between my front teeth has completely closed.  The fresh power chains had done their job to pull that remaining 0.25mm gap together!

That's a total of 478 days (or 1 year, 3 months and 22 days) from when I stopped expanding on April 8th 2013 to the gap being finally closed.  Phew!  Of course this is still not the end - I still have my big surgery to go, but it's a milestone nonetheless.

Here's a photo of my now gapless smile.

Wednesday, July 16, 2014

I've finished paying for my braces!

This was a nice surprise for the middle of the week!  I logged on to my internet banking today to check my credit card and wondered why my orthodontic payment had not been debited this month.  After checking my treatment plan I realised that I actually made my final payment last month.  Of course the payments I have made cover my whole treatment plan so I will continue to be seen - it just means that I no longer have the expense each month.

Time for a happy dance!

Thursday, July 10, 2014

Living with braces - dispelling some myths and my top tips

Braces - those magical things that move your teeth and can sometimes be a complete pain in the butt.  But what is it really like to live with braces?

Before I got my braces I heard all sorts of advice from different people.  Some who had braces themselves many years ago when the technology was not as advanced and others who have braces or know someone who has braces now.  After living with braces for more than a year, I have come to realise that there is a lot of mis-information about them.  So in my own experience, here are the biggest myths about living with braces:

"It's really difficult to eat and you will lose weight"
Oh how I wish this one was true.  Eating can certainly be annoying because of the food constantly getting stuck all around your mouth and there are certain foods to avoid, but I would not say it is difficult.  And unfortunately the weight loss part did not happen for me.

"You cannot eat anything crunchy or chewy"
With braces you do need to be aware of what you eat.  However as long as you are not chewing down on lead pipes, imitating jaws from the James Bond movies or eating raw steaks - you will be fine.  Cut any large or crunchy items such as apples and carrots into small bite size pieces, take your time to chew your food carefully and you will soon figure out what you shouldn't eat and what is just a pain in the ass.

"Wait until you get them tightened - that's really painful"
When I heard this I dreaded my first adjustment appointment.  I imagined that the wires would be wrapped around the brackets tighter and tighter causing me immense pain.  In reality, braces are not actually 'tightened'.  At each appointment (usually every 4-6 weeks depending on your treatment plan) the o-rings are removed allowing your brackets to open, the wire is then removed and usually replaced by a thicker/stronger wire.  While this can be a little uncomfortable, I personally never experienced any pain.

"Don't consume curries, coffee or red wine - you will stain your braces"
As if!  But seriously - this is a complete myth because your braces can not and will not stain.  When you consume these types of food its the o-rings and power chains which discolour, but these are replaced at every adjustment appointment.  Some people find that by using grey coloured o-rings instead of white, they stain less easily.  Personally I like the nice clean look of white/clear o-rings when they are replaced.  And if like me you drink a lot of coffee - use a straw!

My top tips for living with braces

So, there are some myths dispelled.  Now for my top tips on living with braces and how to make the journey as comfortable as possible.

  • Follow the advice of your orthodontist and dentist.  This may sound self explanatory but I have constantly read on online forums - 'Well they told me to do this, but I don't think I need to'.  Seriously, they are professionals and know what they are talking about.

  • Have a top-notch dental hygiene regime.  I cannot stress how important this is.  When you have braces it is even more difficult to clean and floss, so regular visits to the dentist for cleans are imperative.  I go for a clean every 2-3 months and use my Waterpik at home every day (see below).

  • Buy a Waterpik.  This is a device which is also known as a water flosser.  It uses high powered air and water and helps clean between your teeth, between your braces and everywhere in between.  I use this religiously twice a day and it has been one of my greatest investments.

  • Get lots of orthodontic wax - and I mean lots.  Braces rub against the inside of your mouth and can cause ulcers and soreness.  Orthodontic wax is a pliable wax which you can use to coat brackets and wires which rub - reducing discomfort greatly.

  • Invest in pixsters.  These are mini flossing tools which you can conveniently carry around with you.  Make sure you take them everywhere - especially when dining out as food will collect around your braces very easily.  I usually make a discreet bathroom visit as soon as I have finished eating.

  • Be positive!  While braces can sometimes make you dislike your appearance, just remember why you have them and think of the end results.  Positive thinking can go a long way in terms of healing and how you deal with the reactions of others.

That's all for this update and for all you horror movie fans out there, enjoy the related YouTube video below!

Saturday, June 14, 2014

It's been too long - here's an update to my journey

A blog is a big commitment and sometimes it can be really easy to think 'I'll update it next week'.  I've been super busy with work, travelling quite a lot for both work and pleasure and I also moved to a new apartment.  Then I realised that almost a year has passed by since my last post.  I am still very much on my journey and the biggest step is yet to come, so I thought I would finally give an update and will commit to keeping this blog up to date.

So what has happened in the last year?  

To start with the expansion device had to stay in my mouth for a good 3-4 months after the braces were on so my jaw could stabilise.  It was a bit awkward having both in my mouth so you can imagine my joy when it was finally removed - I could touch the top of my mouth with my tongue again!

Since then it has been braces all the way - and my face has changed a lot.  I knew that it would take a while to close the huge gap that was between my front teeth - I just didn't realise it would take so long, but now I am really happy to say that the gap has almost closed.  In fact, there is only a 0.25mm gap right now thanks to orthodontic power chains.  You can see the result for yourself in the photo below - needless to say I am extremely happy with the result.  When I used to smile wide, there used to be huge gaps at each side of my upper jaw due to how extremely narrow it was.  Now my teeth are as wide as my smile.

When you look at yourself in the mirror every day you do not always notice the changes.  Looking at my upper jaw here though - it's amazing to see the changes.  And yes, it's another stupid pose!

I mentioned power chains - but what are they?

Well they are definitely not as scary as they sound.  At first when I heard about power chains I expected metal chains to be placed in my mouth and across the braces.  In reality, a power chain is just a plastic set of links similar to the o-rings that hold the brackets closed on your braces.  They go over the top of your regular o-rings and are quite tight, and that tension pulls the teeth together which in turn closes any gaps you may have.  There are different types of power chains and as the gaps get smaller, so do the links between each o-ring on the power chain.  In the image below, you would start with the power chains at the bottom of the image and slowly move to the ones at the top. 

Other results of the braces

Aside from the closing of the gap, the braces have also greatly reduced the over-jet of my front teeth. I didn't expect the result to be so dramatic because reducing the over-jet has in turn reduced the appearance of the overbite.  I still need double jaw surgery to fully correct everything, but I am well on my way to having a functional jaw.

This side profile shows the reduction of the over-jet

Of course the main function of braces is to straighten teeth and while my upper teeth were always nice and straight, my lower teeth were a mess.  I had a fang on each side of my lower jaw and these were not in line with the other teeth - but the braces soon worked their magic and straightened these teeth out.  In fact this only took a couple of months before there was a big change.

And that's it for now!  I will be posting a couple more updates soon on how to live with braces and the next steps in my treatment leading up to surgery.  Until then, thanks to everyone who has taken the time to read and comment - your support means a lot and your questions are always welcome.