Will It Happen?

I started my antibiotics on Saturday and got two doses in before going to bed that evening.  I woke up on Sunday and felt like a new person!!  I've been feeling so crummy for so long now that I'd almost forgotten what it was like to feel good!  This was a fantastic reminder!  Sunday was a good day.  :-)  Monday rolled around and again, feeling better.  I had to check in with both my dentist and doctor to let them know how I was feeling.  After speaking with Dr. David, she said that although I was feeling better, she was going to call Dr. Posnick and discuss with him what has been happening.  Every time I thought about this, my heart would sink because I've been anticipating the surgery date for so long and to have it postponed would be a bummer.  Well, Dr. David called me back later on Monday to let me know that she spoke with Dr. Posnick and that for now, we're leaving the surgery date where it is!  Yayyyy!!  They're pretty confident that with the drugs I'm on, things will clear up and we should be able to move forward as planned.  To be honest, with as cautious as my surgeon is, I was fully expecting to push the date back right away.  I'm glad I was wrong.  I'm not out of the woods quite yet but each day is better than the last.  The plan is to finish my course of meds, the last day being next Monday.  Then on Tuesday, I'll have to go back into the doctor for a re-check and testing.  I should get results within 3 days and if everything comes back okay, surgery is on.  All my crossables are crossed for positive news and I ask that you do the same!!  :-) 

Not So Fun

Just another quick update.  I've been feeling ill, on and off now, for about a month.  As you know from my previous post, I developed a small gum infection and about three weeks ago, was treated for a UTI. Since I wasn't feeling well and because surgery is in only a couple of weeks, my dentist asked that I see a doctor she works closely with so we could figure out why I'm not feeling well.  Dr. David ran a lot of tests and we've been waiting on the results.  In the meantime, I developed a large lump, this time in the gums of my bottom jaw.  Let me just say at this point that I have the most wonderful dentist in the world!  It's Saturday, I'm in pain and have something obviously wrong.  I call the emergency number, she immediately called me back and said to meet her at her office at 3 pm today.  In the meantime, Dr. David called with the results of my tests.  From the antibiotic I was taking for the UTI, I developed another infection, Clostridium Difficile (C. Diff).  No wonder I've been sick!!  Back to the dentist this afternoon - another infection.  Dr. Penski cleaned out the infection and took great care of me as she always does.  Unfortunately,  my immune system has been compromised and it will take a bit for it to build back up.  I'm now on two antibiotics and Dr. David will be talking with my surgeon on Monday to let him know what's been happening - I'll be very surprised at this point if they don't postpone my surgery.  :-(  I'm sick, I'm tired and I'm frustrated.

My Smile Is Infectious!

Well....little setback.  Went to get my teeth cleaned this morning and turns out the inflamed gums have a small infection.  :-(  Nothing that can't be taken care of, but nonetheless, it's a pain because we have to get it cleared up before surgery!  The doc will be prescribing antibiotic and I have to go back next Thursday, the 29th, for a re-check to make sure things are healing up nicely.  I did get my teeth cleaned, though and boy, does it feel (and look) good!  :-)

Clean Me Up!

Dental appointment this morning at 11:50!  This will be my final cleaning before surgery, which is very important because I won't be able to have any dental work done for some time post-surgery.  I also have to have them check out my gums.  For the last week, I've had some inflammation over my front teeth that has been a little uncomfortable and looks terrible!  We need to make sure there's no infection going on and fix whatever it is that's happening.  Let's hope it's nothing!

Mock Surgery

Had my final appointment with Dr. Posnick yesterday.  This was to look at what he'll be doing during the surgery.  VERY interesting!  Here's a picture of what he puts together....then let me explain.

On the white plaster (top and bottom), the vertical lines to the left are where my jaws sit now.  The green plaster is the mold of my jaws and where they will sit after surgery.  You can see vertical lines on those, too.  If you compare the lines (the left ones), you can see the distance he'll be moving each jaw forward.  My top jaw will be moving 5 mm.  My bottom jaw will move 1 cm.  The top jaw will also be moved down a small distance and the bottom jaw will actually move up a bit to meet the top jaw.  You don't see my chin on this model, but as I explained earlier, he will be correcting its position, as well, so that everything on my face is symmetrical.  My chin will not be moving out much, but instead it will move down...to lengthen it.  He will be moving it down anywhere from 5 to 8 mm.

There is one element of the surgery that we didn't know until yesterday and Dr. Posnick didn't know until he actually put the models together to do the mock surgery.  Apparently, my top jaw is a bit more narrow than the bottom jaw and if he were to just move each of them forward to meet, I still would not have a correct bite.  In order for them to meet properly, he will also be splitting my top jaw in half to widen it to meet the bottom.  It will not be split a great distance, but enough to make top and bottom match.  This will not make the healing a longer, but just a little more difficult.  The issue is that the top jaw will want to go back to its original shape (narrow) so it's important to keep it in exactly the right position.  In order to do this, I will have a splint in my mouth for the first 5 weeks after surgery that will allow my jaws to rest in their final surgical positions.

The pink splint is the one that will be used during surgery to keep the jaws in line.  The white splint is the one that will be in my mouth for 5 weeks post-surgery.  Once the splint comes out, it will be up to my orthodontist to continue to make the correct adjustments on my braces in order to maintain the width of my top jaw.

Whew......that's a mouthful!  (yes, pun intended...haha)

Cleared for surgery!

I had my pre-op physical on Tuesday with a new doc I found here in Arlington.  Loved him!  His name is Dr. Zweig - super nice guy and very thorough!  Nothing special had to be done for my physical, just some blood work and a pulmonary test.  The first pulmonary test I did wasn't so good.....the doc came in and said that if the readings were right, there was no way that he would clear me for surgery!  Sweaty palm time!  Well, it turns out I didn't do the test correctly so he had me re-take it.  I passed with flying colors so my lungs are good!  I received a phone call yesterday afternoon that my blood work came back normal and that I am officially cleared!  Yayy!

Progress...

Here are three sets of pictures from the surgeon.  The first are the pictures they took at my first appointment.  The second set is when I went in to have my first set of molds done after having had braces for a few months.  The last set are the pictures they just took at our last appointment when they took the final models.

The Bare Bones...

Yesterday was our visit with Dr. Posnick (surgeon) for my final jaw models, to discuss all the elements of my surgery and to answer any questions we had.  Boy, did we!  I'm SO glad Brian went along to this appointment.  He's always got good ideas and he asks the things I would never even think about!

Here's the scoop.  First, we took more pictures of my teeth and face.  Brian got to come in and watch them and even saw the hideous plastic things they make me stick in my mouth to pull my lips away from my teeth.  We giggled the entire time!  Then they did my models, which means they put that nasty tasting stuff in the trays and cemented them to my teeth for 30 seconds to get a mold of each jaw.  Let me tell you, that stuff is not fun to get out of braces!  At this point, Dr. Posnick came in to take a look at things.  They attached what looked like a torture device to my head to take measurements, and the Doc kept pinching my upper lips with his fingers.  Brian said after the first couple of times, I looked like I was ready to slap him.  LOL  I never did ask what he was doing.....I'm not sure I want to know.  While Brian and the Doc chatted, Neil (a resident of Dr. P's) took more measurements of my teeth and jaws and asked numerous questions of me like, "where is your jaw pain", "do you have clicking or popping", etc.  Then it was time to get down to the nitty gritty - what to expect a month from now when I have this procedure done!

The surgery itself will take about 3 hours.  He'd originally told me it would take 5 so I was more than pleased to hear it wouldn't be as long!  At this point, he knows that he'll be moving my upper jaw out approx. 5mm and then down.  My bottom jaw isn't quite as easy - it will need to come out a good distance to be where it should be, then another 5mm to match the upper jaw.  The distance is TBD - I'll know more when I revisit him one more time.   He'll also be lengthening my chin.  It turns out I'll have a gap from extending both my upper jaw and my chin.  Something needs to fill those gaps.  That filler material?  Bone!  He tells me that I'll need a bone graft for those places, but that I've got two options.  The first one is the most obvious...he would make a small incision (during surgery) in my hip and take my own bone.  You're gonna love the second option!  Freeze-dried cadaver bone!  Yep, you read correctly...bones of a dead guy (or girl, of course).  As is expected with me, as soon as I heard that, I got the giggles.  lol  I can't help it.  We asked all the right questions: "What are the risks of my own vs. cadaver bone?", "Is there a reason why we would do one over the other?", etc.  If they take my own bone, there is obviously some extra pain and recovery time.  Dead guy bones?  None.  There was no overwhelming evidence pointing us towards using my own bone, so.....freeze dried it is!!  How cool is that?  :-)

When I'm out of recovery, I'll be moved to ICU for the rest of that day and overnight and if all goes well, I'll be moved out and into a regular room.  Apparently there's a lot of bleeding afterward and unfortunately, much of it is swallowed so there's a good possibility that I'll get sick.  In the (unfortunate) event that happens, I'll have the care I need to be able to get through it.  Once I'm in a regular room, it's another night in the hospital.  They'll teach both Brian and I all the care techniques we'll need to know and Dr. Posnick said I won't be discharged until we know everything very well!

Day Three.....if all goes as planned, I'll be able to head home.  I'm already looking forward to that day!  For the first two weeks, aside from having my computer on my lap or watching t.v., I can't do a thing.  At two weeks, if I'm feeling up to it, I can return to work but in a very limited capacity.  Basically, I can sit at my desk and use the computer.  Not sure how well this will go since I don't like to sit still for a long time.  I'll be eating through a syringe at the beginning, strictly liquids.  The doctor said that if I'm feeling well enough after a week, I should be able to drink some liquids from a glass rather than use the syringe so I'm hopeful this will be the case.  Liquid diet for 6 weeks, and then I can slowly move into some solids.  Probably the worst part in all of this is that I won't be able to talk - or talk well anyway!  For those of you that know me, you know this will be the most difficult thing I've ever had to endure...LOL.  Brian will probably be a happy man!  hahahaha 

So, I'll have two bands on each side inside my mouth that are attached to the hooks on my braces.  These are there to keep my jaws in a good resting position.  Right after surgery and for the first couple of weeks, the muscles will be sore and damaged so I won't be able to move my jaw, even if I wanted to.  However, once a week for 5 weeks, I'll visit Dr. Posnick, he'll remove the bands and will have me exercise my jaw, then the bands go back on.  At our last visit, I must say that my mind was put at ease a little bit.  I was very concerned about a few things..."What if I sneeze and open my mouth quickly?"  "What if I cough and my mouth opens?"  "What if I have to yawn?"  I was concerned that any of these things might happen and I would do damage to what had just been done.  Not the case.  If my mouth opens, that's a good thing and it means I'm healing.  It won't do any damage.  In fact, he said that sometimes people get a little claustrophobic and feel a little closed in having the bands on.  He told us that if I feel panicky like that, to just go ahead and snip the bands, get over my panic attack, then call him and he'll replace the bands the next day.  Simple as that! 

Lots of information to take in, but we're learning.  Brian's been wonderful and is learning along with me.  We go back in next Monday - the molds are done and Dr. Posnick has done the mock surgery!  We get to see where my jaws will be when everything is all said and done!  Yippee!!