SARME Surgery post-op day 33 - mind the gap!

It's been a few weeks since I posted to my blog, because to be honest nothing much has been happening apart from the gap getting bigger and bigger!  I've become quite self conscious (although not  enough to stop me from posting this) because the wider the gap has become, the more you notice the slant in my jaw.  This has led me to covering my mouth a great deal while out in public and I have become quite sensitive, even dare I say, high maintenance.  Of course I always knew that my jaw had grown downwards at a slant - the gap just exaggrates it greatly and I'm looking more and more like Cletus from The Simpsons.  The slant in my jaw will be fixed up though through a combination of the braces and my jaw re-alignment surgery next year.

The exciting news is that I went to see my orthodontist on Monday and they instructed me to stop turning the expander as the upper jaw has now been widened enough.  So that's a total of 25 days expanding twice a day, and I'm quite glad that stage is over.  While expanding never caused me any pain as such, I did feel a lot of pressure on my jaw after each expansion.  As each expansion was only 12 hours apart - the pressure was almost constant all day, every day.

Anyhow they do not call it a rapid maxillary expansion for nothing, and the photo's below show my expansion progress since my last blog post.

Post-op day eight (six days turning the device)

Post-op day twelve (ten days turning the device)

Post-op day 20 (18 days turning the device)

Post-op day 28 (26 days and the turning has stopped!)

In five weeks time I will be getting my lower braces on - I'm quite looking forward to that.  The upper braces will not be able to go on for a further four weeks though as my upper jaw needs time to heal in the new position.  This does mean the gap will remain for at least nine more weeks until the braces can start closing the gap, and the expansion device will need to remain in my mouth for that length of time, but at least things are moving along.  I still have virtually no feeling in my upper jaw or gums, but now the jaw has started healing the feeling should start to come back.  I have been advised though that it could be a number of months for the feeling to fully return.

Eating is still a chore and while I can eat semi-solid food, I still cannot eat anything too chewy or crunchy.  I've been making up for it with the soft foods though and have been eating so much yoghurt that I've put on a couple of kilos!

As a last note, I had a really strange dream last night (which was partly red wine fuelled) where my front teeth fell out and new ones instantly grew in their place.  I think this highlights the anxiety I have been feeling, but I'm still in good spirits.

Over and out.

SARME surgery post-op day seven - Look at my gap!

It has now been seven days since my SARME surgery and I'm glad to say that everything is going pretty well.

I went to see my Maxillofacial Surgeon for the first time since the procedure and he has commented that my gums are nice and pink and that I look like I am healing fast.  I still have no feeling in my upper teeth and my gums are completely numb, but he has said it can take months for the feeling to come back!  I mentioned to him my concern over one side of my jaw sitting slightly lower than the other, but he assures me this is normal and that it will be fixed up during both orthodontics and my bi-maxillary surgery next year.

I'm really surprised with how quick my upper jaw is widening.  I know I said before that it would widen by 0.25mm with each turn and yes I know it's called a 'rapid' maxillary expansion, but I didn't realise how quickly it would become a large gap.  After four days of turning the gap is extremely noticeable and I am able to do all sorts of tricks with my gap such as whistle or direct a stream of water through it.

Anyway that's all for now - enjoy the photos below and check out my sexy (not) gap!

I'm sexy and I know it

I can almost fit a straw through the middle

SARME surgery post-op day three - I've started turning!

Three days after my SARME surgery and I am still feeling no pain, however I have been extremely exhausted and sleeping loads.

Today I went for an appointment with my orthodontist to start the adjustments/turns on my expansion device.  I freaked out a little inside when he put the mini spanner into my mouth and shook (quite visibly) as he made the very first turn.  I was so convinced that it was going to hurt, but to my surprise it didn't.  My orthodontist gave me instructions on adjusting my expander and within five minutes I was finished.

The SARME surgery on Monday split the jaw bone which allows the upper jaw to move and now by turning the device I am making my upper jaw wider.  This is not a slow process (theres a reason they call it 'rapid' maxillary expansion) as my jaw is widening by 0.25mm with each turn.  After the first turn by the orthodontist I could already notice a gap (however this did not come out in the photo below) so it's reasonable to say that I will be looking like Cletus from The Simpsons in no time.  

That's all for now - just a quick post.  I will update more in the days to come.

SARME surgery and post-op day one

The big day has come and gone so I thought I would give you an update on the surgery and my recovery since then.

I had to report at the hospital at 1.30pm on Monday 11th March, which meant that I couldn't eat after 7am that morning.  I couldn't sleep well anyway as I was nervous so I was awake and having breakfast at 6am.  I pottered around as much as I could Monday morning (including making the last video) and then set off to the day surgery in Randwick.

I still felt nervous on arrival but the team of nurses and my anaesthetist came to chat to me at different times to go through various questionnaires and I felt confident in their hands.  They advised me that I wouldn't be having the four teeth removed at the same time as my surgeon and orthodontist had decided they would come out later.  

The day unit was a little different than a hospital ward, and I had to wait in reception until they were ready for me.  As soon as they called me through it was time to gown up and go straight through to theatre - no sitting around in a hospital bed for me.

Giving away my age again

In theatre I saw my surgeon Dr Tsakiris who came to assure me that I would be ok everything would run smoothly.  I feel so confident with him that any nerves or worry I had started to disappear instantly.  I also saw Andrew again (the anaesthetist who came to originally talk to me) and while all the team were busy with their jobs their focus was on me - asking if I was ok, keeping me chatting about what I did for work etc.  The drip went into my hand and before I knew it I was breathing oxygen through a mask.  I remember the coldness of the anaesthetic going into my hand and remember saying 'that feels good' before drifting off to sleep.

This was only my second experience of general anaesthesia and it felt like I woke up as soon as I had fallen asleep.  The surgery actually took around 1 hour and 40 minutes.  I was a little groggy when I came around and kept drifting in and out losing track of time, although I did feel quite relaxed.  I remember the nurses calling my escort to come and pick me up, and it felt like only seconds later until he arrived, even though it was 30 minutes.  My surgeon came and spoke to me and said that everything had gone well.  After a short while longer in recovery I was on my way home and soon enough was resting up in bed.

On my way home from the hospital

Resting up in bed

And so here I am one day after my SARME surgery.  I have been quite surprised with the pain levels in the fact that they have been low to non-existent!  I guess I must be very lucky as I have read from other blogs that people have been in tremendous amounts of pain after this procedure.  I am religiously taking the antibiotics and the panadeine forte (very strong painkillers) they prescribed me so the pain does not creep up on me.

While there has been no pain there is a lot of pressure and numbness on my upper jaw and the swelling is very, no extremely noticeable - think Joan Rivers meets Alvin and the Chipmunks.  

I am not allowed to spit or blow my nose for two weeks and this is because the sinus walls are damaged during this kind of surgery and need to repair.  I'm not even allowed to sniff which is frustrating as my nose is clogged, but I have been prescribed some nose drops for this.  Sometimes I have sniffed without realising which has caused some blood to come through to my mouth, but not tremendous amounts.

So what else can I say?  Well apparently a lot because I have not lost my ability to talk!  I thought it would be too painful but if you watch the video below you'll realise I'm the same old me!

The day of my SARME surgery

It's the day of my jaw widening surgery (SARME) so I thought I'd let you hear it from the horses mouth!

Maxillary expander update and three days until surgery!

My expander has been in for three days and I must say I'm getting used to it quicker than expected.  My speech is not half as bad as it was on Tuesday (I no longer sound like Joseph Merrick) and it's now only certain words and sounds that I have difficulty with.  Eating is still a challenge as food constantly gets stuck between the device and the roof of my mouth, but nothing that gargling water after every meal doesn't cure.

The strange thing is that since having my expander in my sense of smell seems to have heightened.  I did not expect this to happen and haven't read it in other peoples experiences so it came as a surprise, but I must say it's a rather pleasant surprise.  I seem to be picking up smells that transport me back in time to a place with fond memories - spices in an Indian market, the smell of damp English soil when camping as a child, the smell of the sea breeze on San Francisco Bay.  Call me crazy, but they do say that if certain senses are limited, the others compensate for them.

Aside from this it is only three days until my surgery and I am starting to get a little nervous.  However, I am in the care of an absolutely fantastic team who make me feel comfortable and I have every confidence in them.  Dr. Peter Tsakiris is my Oral and Maxillofacial Surgeon and will be performing the SARME surgery on Monday, Dr. Steve Stromotas is my Orthodontist (who also has an amazing, friendly and professional team of staff) and will be assisting me with the expansion device and later my braces, and my dentist Dr Kenneth Wong is keeping my dental health at top notch condition.  That's enough love for one thread!

So what am I doing this weekend?  Well apart from stocking up on mashed potato, soup, protein drinks and other soft meals I am going to make the most of my oral freedom <insert naughty pun here>.  I have some friends coming for dinner on Saturday evening (I love to entertain) and will be chilling out on Sunday and catching up with as many people as I can on the phone while I can still talk.

I'll be updating this blog pre and post surgery so watch this space!

The expander is in!

I finally got my expansion device in today in preparation for my SARME next week on Monday and for the first time I have started feeling nervous!  The expander only took 15-20 minutes to be installed and glued into place, and after a quick check by the orthodontist I'm ready to go.

Learning to speak with the expander in is a lot of fun as I suddenly have a very prominent lisp.  Add to that the constant swallowing from the excess saliva and it all adds up to a rather attractive package!  I haven't tried to eat anything yet but have been warned to stay away from any sticky foods - so goodbye chewing gum, sweets and caramel :(

While I'm feeling nervous I am also excited as it means things are now moving along.  I can't wait for my SARME surgery next Monday and will keep this blog updated of my progress.

For now here are some photos showing the expander in my mouth as well as some side pictures which show the metal rings of the expander attached to my teeth.  Not very attractive camera angles but what can you do?

When my palette is split in half this device will widen my jaw

The metal rings surround two teeth on each side of the upper jaw and are glued into place

Another attractive shot

With this ring, I thee bled!

Ok, so grammatically the title of this post is pretty rubbish, but hey - I'm trying to be funny!

I went back to the orthodontist on Tuesday - just 24 hours after having my spacers put in.  The spacers were removed and the rings (which will eventually be connected to the SARME / expander device) were sized for my upper molars and front upper teeth.  I think I had become complacent about pain as the spacers did not hurt or cause any discomfort - but I can tell you, having the rings fitted soon kicked me back to reality!

The process of sizing the rings involves sliding various different metal rings up over the teeth in question (quite roughly I might add) in order to find ones which are the perfect fit around the tooth - not too tight and not too loose.  The rings hit my gums a number of times and I could feel the edges of them against the inside of my cheeks as well as against my tongue.  This caused some discomfort but luckily the whole process only took 20 minutes or so.

Once the metal rings were fitted I had some impressions made and the rings were removed - phew!  The impressions will be sent to the lab to have the device built and this will be 'installed' on 4th March. Oh happy day!