Still Waiting...

No word yet from the insurance company as to how much of my surgery insurance is going to cover.  When I initially called them and gave them the codes from my surgeon, all but two of the procedures were covered and the other two needed "more information".  Fortunately, none were declined right off the bat.  So I guess it's hurry up and wait...

Liquid Diet - Trial Run

Well, we tried a couple of the recipes below.  I must say that creamed asparagus isn't nearly as bad as I thought it would be.  It was tasty and definitely an option so that one stays on the "Good" list.  To change things up, we added some chicken to it and it was even better.  Also tried the Breakfast Protein Drink.  This one will take a little more getting used to, but all in all, it was all right.  Of course, the smoothie was a hit!  We've also decided that each night when we make dinner from now on, no matter what it is, we're going to put some to the side and throw it all in the food processor and see what happens.  It might prove to be fun!

Cream of Anything

Since I'll be on a liquid diet for a minimum of 6 weeks, we now face the daunting task of finding recipes to make that are easy, yet edible!  At the beginning, protein supplements, smoothies and shakes will be on the agenda.  But understandably, those are going to get awfully boring!  Today is shopping day!  The plan is to get ingredients for a few recipes we've found to see what we think.  Here's what we're cooking today:

• Creamed Asparagus
• Cream of Corn Soup
• Breakfast Protein Shake
• Mashed Potatoes & Gravy
• Banana Yogurt Smoothie

 Should be interesting.

Orthodontic Pictures

Here are pictures taken on my first visit to Dr. Gerlein's office in April 2009 of what my teeth and bite looked like.  Click on the thumbnail below for a larger view.  More pictures to follow.

The Technical Side of Things

In case anyone is interested in the technical side of things, here they are:

Dr. Gerlein (Orthodontist) - Diagnosis:

• Gingival margins in the maxillary anteriors are uneven
• Thin gingival tissue morphotype with localized areas of recession on the bicuspids
• The front teeth in the upper dental arch are retrusively inclined
• Lower front teeth are too far behind upper front teeth
• Overbite is severe
• Moderate maxillary crowding
• Mild mandibular crowding

Dr. Posnick (Surgeon) - Diagnosis, Conclusion & Plan:

Diagnosis:

• Jaw deformity with malocclusion
• malocclusion characterized by Angle Class II deep bite
• Angle Class II deep bite affects occlusion/chewing/bite; speech articulation and lip closure/posture
• Grinds and clenches teeth
• Gingival recession especially in the labial aspect of the posterior maxillary dentition

Conclusion:

• Jaw deformity best corrected with orthodontic decompensation, followed by jaw surgery then finishing orthodontics

Plan:

• Bilateral sagittal split osteotomies of the mandible with advancement
• Le Fort I osteotomy with horizontal advancement, vertical lengthening and transverse widening
• Chin osteotomy
• Septoplasty

Fast Forward

I've now given the basics of what's happened in the last 9 months and we'll fast forward through to the present.  Wow, I can't believe I've had my braces on for 9 months, it's incredible!  The time has flown by and to be very honest, even though I still don't like them, they aren't THAT bad.  Don't get me wrong, I absolutely can't wait for them to be off my teeth, but I'm dealing with them rather well, I think.  At first, I was embarrassed and didn't want anyone to notice them.  Now I have a great time at each visit to the orthodontist when I can pick fun colors!  I've got them, might as well show them off, right??  What's really crazy (to me, anyway) is that on March 30th, I have my next orthodontist appointment - this time to stop the movement on my teeth!  It's nothing to be giddy about though, it doesn't mean that I'm done with orthodontia just yet.  But, it does mean that we're on schedule for surgery.  What has to happen is that on the 30th, they'll put new wires on my teeth that will no longer allow my teeth to go anywhere at all.  They have to do this because I see the surgeon on April 7th and at that time, he'll take my final mouth molds.  He will actually use these final molds to do the surgery on them before he does it on me, so that he knows exactly what he has to do.  Brian and I will be seeing the surgeon together this time so he can explain everything to us in detail about what's going to happen before, during and after the actual operation itself.  There's SO much to know and learn.  What I do know so far is that I will be in the hospital for three days.  My mouth will not be wired, but banded shut.  I will have very little movement of my jaw for the next 6-8 weeks.  I will have to visit the surgeon once a week for 5 weeks and each time, he will apparently take more bands off as the healing progresses.  During the first 6-8 weeks, I will be on a strictly liquid diet and will eat for at least the first few weeks with a syringe.  Once some of the bands come off and I begin healing, I'll slowly be able to use a small spoon or sippy cup but the food will still need to be the consistency of a puree.  I will not be able to talk much at all (oh dear, what will I do???) and will use a dry erase board to communicate at first.   I will have a large amount of bruising and swelling throughout the first 6 weeks and they've said I'll lose 25-30 lbs with the liquid diet and once the swelling and bruising go away, I will look very different.  I hope to return to work 2-3 weeks after surgery.

What I've told you above is the main reason for this blog.  I will continue to post from this point forward as I know more.  I'll also be posting pictures.  What a change this is going to be!

Surgical Preparations

Not all insurance companies like to pay for jaw surgery.  So, in order for us to get all our information together to submit to UnitedHealth, I've got some work to do.  I have to visit a Speech Therapist, an ENT and Dr. Posnick also wants me to have a sleep study done, which I'm still not quite sold on.  So I visited the Speech Therapist first and learned a lot!  She asked me some questions that some people would think were a little strange - "Do you chew predominantly on one side?"  "Do you completely chew your food before you swallow it?"  Well, come to think of it, I ONLY chew on my left side and I never chew food down to a small piece.  Why, you might ask?  Well, chewing for me is literally a pain in the jaw.  It's very difficult and a huge strain.  So, the less I have to chew something, the better off I am.  Luckily, I haven't choked on anything yet!  :-)  Back to the speech lady - I had to say the alphabet and read statements that were typed on a piece of paper.  All in all, the appointment took only a short time and she sent me on my way, telling me that she would send the report to my surgeon.  Next up, the ENT, who confirmed my deviated septum which will also be taken care of at the time of my jaw surgery, as it's very simple to get to and complete and hey, if they're already in there, why not?

Adult Orthodontics

May 25th, 2009.  So obviously I went back to see Dr. Gerlein to tell him he was right (well, halfway anyway) about the jaw surgery.  He did more x-rays, more molds and today was the day I got my braces on.  I was NOT excited!  I love to eat and I knew it was really going to put a damper on that!  The whole process was really quick, it only took about an hour, and I instantly didn't like them.  I felt like when I smiled, the braces stuck out about 2 feet!  To say I was self-conscious is an understatement!  Eight weeks till my next appointment.  I pouted all the way home.  Fast forward about two weeks - they were annoying, but not necessarily painful.  I was having a very difficult time chewing and could never quite find a comfortable way to do it.  And the food that gets stuck in the braces - whew!!!  Thank goodness for all the little brushes and picks Dr. G gives me or I'd go crazy!

The Very Beginning

Hi everyone!  I've decided to start a blog to chronicle my journey through adult orthodontics and also through my upcoming jaw surgery.  Let me tell you how this all started.  I'd gone many years with pain and discomfort in both jaws, primarily the lower.  The strain from talking, yawning, chewing - you name it - was irritating.  My dentist wanted to refer me to an orthodontist.  I was a bit leery.  What would it cost?  What needs to be done?  How long will this take?  I'm nearly 40 years old, I can't have braces!!!  After much prodding by my wonderful husband (bless his little heart...lol), I decided that it couldn't hurt to meet with the orthodontist and get more information.   April 2009 was my first appointment - I walked into the office of Dr. Gerlein in Chevy Chase, MD and knew immediately that I was in the right place! After numerous x-rays and an exam, the verdict was in.  My jaws were a) too small and b) not growing correctly, hence the pain and difficulties I was having.  Dr. Gerlein said it looked like I would have to have surgery on my bottom jaw to bring it forward, but that before he did anything, I would need to see a surgeon to confirm his diagnosis.  Next step - make an appointment with the surgeon.  May 2009 I meet with the surgeon, Dr. Posnick, also in Chevy Chase, MD.  They already had my x-rays from the orthodontist, but still needed to take lots of pictures inside my mouth for the doc to see, as well as molds of my teeth.  The sit down with Dr. Posnick went well, although it was a little overwhelming at first.  He did confirm what Dr. Gerlein had said, that I would need surgery - but on not one, but both jaws and my chin.  The plan would be to move both my upper and lower jaws forward and down.  Same thing with my chin, to make everything symmetrical.  Then, while they're in there, they'll repair my deviated septum, as well.  But before any of this happens - braces!  And the story begins...