Tax time and medical expenses

For those of you in Australia and keeping up to date with tax laws, you will know that as of today - 1st July 2013, the Australian government has done away with the net medical expenses tax offset.  The tax offset helped people who spent a large amount of money on medical expenses during the tax year, by providing a rebate of either 20% or 10% over a set threshold - depending on your income.  The offset had been declining over the years, so I guess it was inevitable it would go - however this will affect a lot of people, especially pensioners who spend a lot of money on medical services.

What a lot of people don't know (and I only just found this out myself) is that while as of this year it has been scrapped, if you claimed the offset in the 2012-2013 tax year, you can also claim it in 2013-2014. And if (and only if) you also claim it in 2013-2014, you will be able to claim for one final year in 2014-2015.  This is great news for people like myself who are due to spend another $20-$30K or so.  It won't stop the government further raising the threshold and lowering the rebate, but at least it's something for the next couple of years.

That's it - just a quick post really, but useful information for those who need it.  And remember, if you did claim it in 2012-2013, ensure you continue to keep good track of your medical expenses.

Before and after jaw widening

Throughout my whole SARME experience I have of course noticed my jaw getting wider.  This is mainly because of the gap that has formed between my front teeth.  However because I look at myself every day, I don't think I realised just how much wider my jaw actually is.  Last night I took a photograph of the roof of my mouth and compared this to the same photograph I took before the surgery/widening and I am truly amazed at the difference.  So here are the photographs side by side, so you can see the difference too!  When I look at these, I have no doubt that I am doing the right thing.

Enjoy the lovely nostril shots...

Pass that paper bag

It's been a strange few days.  Last weekend I suddenly became extremely self-conscious and aware of the stares I get in public due to the gap in between my front teeth, and a Facebook post where I vented my frustration prompted an interesting conversation with a very good friend.

Why am I worried about people staring at me, when I have this blog which is showing my jaw (and journey) for all to see?

I thought that was a very good question because my blog if anything, is quite explicit in the descriptions I give and the photographs I share.  To me, it comes down to control and context.  When I post an update to my blog I am putting my face right out there for all to see.  And while I have no control in who reads the blog, the reactions of people who read it are not displayed to me right away.  If someone is reading my blog, they know I am going through surgery and so for my readers, things are put into context.  This is quite different to what happens in public.

When I am out and about in public, people stare.  They can't help it but they just do.  I have had people stare so much that I turn around and they are still looking.  On one occasion the stares have led to all out laughing which was very obviously directed at me.  The issue is this - they do not know I am having jaw surgery, they do not know this is all part of a larger plan and they do not know that I haven't been in a fight and had my teeth knocked out (because after all, I am quite butch).  Of course I don't blame people for looking because unlike my blog there is no context, however after a while the stares make me uncomfortable.  Of course the laughing to me is another matter and just plain rude, and prompted my Facebook frustration.

So there is a bit of an insight into how I am feeling and why stares in public are very different to someone reading my blog!  It has definitely highlighted my coping (or lack of) mechanisms and this is something I will be working on.  On a more positive note, this situation has prompted me to contact my orthodontist who has said they can put some temporary composite (the same material fillings are made from) across my front teeth which will disguise the gap.  It won't look like a tooth, but I won't have a huge gaping hole either so in the short term I can get back to looking fairly normal.

Now all I need to do is wait until the upper braces are fitted and the gap starts to close...

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!

X-rays, photographs and projected outcomes

I thought I would now share with you some of the x-rays, photographs and projected outcomes in the report from my Maxillofacial Surgeon - Dr Peter Tsakiris.  I've had the report and images for a month or two, but it has taken me a little while to find the courage to upload them because the images really highlight the extent of my jaw abnormalities.  However this blog would not achieve it's purpose if I didn't share them, so here you go.  You can click on any of the images to view a larger version.

In the first x-ray (front view) you can see how my jaw has grown down too far covering my lower teeth.  The x-ray also shows that my upper jaw sits at an angle.  The side x-ray shows the extent of my overbite (upper jaw being further forward than the lower) but also the overjet of my upper teeth (the angle at which they are protruding outwards).

Current view of jaw from front

Current view of jaw from side

My last post talked about my SARME surgery which is the very first stage due to take place in a couple of months.  This surgical procedure will see my palette split in half to allow the expander device to widen my upper jaw.  A few teeth will also be removed during this procedure.  The below images show the expected changes in my jaw after this first stage.  As I stated before, this is actually the least invasive of all the surgical procedures.

First stage projections - SARME

The next set of images show the final expected outcome after stages two and three.  Stage two will involve wearing braces for a period of 8-9 months, and stage three will be the main double jaw surgery which will see me in hospital for a week.

As you can see my jaw will not only be wider, but also more square with the upper jaw being lifted up a further 2mm.  This will be quite a dramatic change as the length (and shape) of my face will completely change.  This is achieved by the removal of different parts of the bone in the upper jaw taking it both up and backwards, while the bottom jaw will be split and extended further forward using implants.  I will also have a genioplasty which involves an osteotomy of a piece of the chin bone, which will then be slid forward or backwards depending on the shape of my face.

Final projected outcomes - front view

While it's quite difficult to see - the final images show the expected changes from the side profile.  Again, click on any of the images to see a larger version.

Final projected outcomes - side view

These images are only projected outcomes and the treatment plan will evolve as I move through this journey, depending on movements made by orthodontics and other factors.

Well that's it for this post - if you have any questions please feel free to send me a message or leave a comment.  Next update soon!

The journey begins

What is this blog about?  Well, it is an honest account about my face and how I am planning to change it.

I have been unhappy with my smile for a very long time due to having an extremely prominent overbite (13mm), an overjet of my upper teeth, a narrow upper jaw and a gummy smile.  In fact this unhappiness has been with me since I was a very young child and teased for my looks.  I was called everything from 'buck-teeth' to 'goofy' and this has stayed with me throughout my life.  And so I thought rather than wallow in shoulda-woulda-couldas any more, I would do something about it.

If you are reading this blog, chances are you are doing so because we are kindred spirits, you are a family member/friend of mine or you were randomly redirected here while watching videos of cute kittens on YouTube.  Whatever your reason for reading this, I will attempt and explain what some of the issues with my jaw mean:

• Overbite - the official definition of overbite is 'a malocclusion of the teeth in which the front upper incisor and canine teeth project over the lower'.  That's a mouthful in itself (pardon the pun) but in layman's terms - my upper jaw is set much further forward than my lower and the jaws do not meet correctly.
• Overjet - not only is my upper jaw set much more forward than my lower, my upper teeth have also grown out at an angle instead of vertically.  Thank you Mother Nature.
• Narrow jaw - it is simply that, narrow.  When I smile my teeth do not go across the width of my smile as my jaw is too narrow.  Instead you see gaps (aka the Grand Canyon) in each side of my mouth between my jaw and the sides of my mouth.
• Gummy smile - not only did my upper jaw grow much further forward than my lower, it also grew down too much meaning that I show too much gum-line below my upper lip.

It all adds up for a smile that is pretty out of whack, or 'unharmonised' as my Maxillofacial Surgeon much more eloquently puts it.

So finally after years of wishing I had done something about this, I decided to start the ball rolling on my way to facial harmony.  Now this journey actually started about a year ago, but before I could think about moving towards a better face I needed some major restorative dental work.

You see, I had a pretty bad addiction when I was younger.  I was addicted to Coke.  Now before you start calling me a 'crack whore' (I should be so lucky), I am of course talking about Coca-Cola.  I couldn't get enough of the stuff!  Now as a much more mature person I hardly touch sugary drinks, but the damage was done.  Three fillings, two root canals and multiple cleans later, not to mention three teeth that will need to be extracted (ok so it could have been worse) and I am finally on my way.

So why am I starting this blog now?  Well after a move from the west coast of Australia to the east, I have found a great dentist, orthodontist and Maxillofacial Surgeon.  My treatment plan has been put in place, and I signed my first lot of paperwork today!  This treatment plan will be in three main stages (with the first stage in March 2013) and will consist of:

1. SARME (Surgically Assisted Rapid Maxillary Expansion) otherwise known as SARPE where the 'P' stands for 'palatal' instead of 'maxillary'.  This is a surgical procedure where I am put under general anaesthetic, an incision is made through my upper palette (yes it's split in half) and my jaw is widened.  I'll write more about this closer the time, but in the grand scheme of things this is the easiest stage of my treatment plan!
2. Orthodontics - Oh the joy of having braces.  I will have upper and lower braces fitted around 6 months after the SARME surgery which will bring my teeth in and close the gap between my front teeth that the SARME will create, as well as realign some other teeth.
3. Bi-maxillary surgery - this is by far the most major part of the plan and is double jaw surgery where both jaws are broken, various bits of jaw bone are removed, my lower jaw is extended forward and my upper jaw set back.  This surgery will be undertaken around 9 months after the braces go on.  Again, more about this later.

Still reading?  I'm impressed!  Well hopefully by now you are intrigued, impressed, interested or even infatuated.  Let's be honest though, even if you are totally bored and wanting to gouge your eyes out with safety teaspoons (is there such a thing?) to avoid reading any further, I still appreciate you looking.  Can anyone say attention whore? 

Of course you may have gathered by now that I love to talk, or type, or both - but my first blog post is now coming to an end.  

On a serious note, this will be a life changing journey for me (and my bank balance) and I am writing this blog to educate and entertain.  I hope you will follow me on my journey, and feel free to subscribe using the button within the 'Followers' section on the right hand side of the page.  Or simply comment, share and do whatever else with me that you will.

Ciao