Saturday, May 30, 2009

36 Activations Done!

So my new expander is now in. All in all, it was not as uncomfortable as I thought it would be (I feel I've been saying that about everything so far....which is a great thing I guess!).

The one thing I did notice over the past couple of days is that the gap between my teeth looks and feels smaller. I have 12 activations to go, so ultimately it will probably be bigger than my most recent pictures, but it's nice that it's starting to close on its own.

There's not much else to report. I'm seeing Dr. Roy again on June 10 to make sure I'll be ready to go for June 17. I'll be sure to update you at that time, and may post some new pictures!

Take care!

Thursday, May 28, 2009

33 Activations Done!

As promised, I'd update the blog on yesterday's ortho appointment. I had to go in to have another set of molds done to make my new expander. I had activation #33 before going in that morning.

It was pretty uncomfortable to have my current expander taken out to do the molds. My jaw is still numb and it does feel painful to bite down hard, so having someone in there pulling the expander off with some force did hurt a little. Once it was off, everything was fine though. Obviously, with the expander off, I got a sneak peek of what the roof of my mouth will feel like. It was HUGE. I'm sure that's partly because just having the expander in there takes away half the space in your mouth, but the other part is that it's almost a full centimeter wider.

My orthodontist told me that I was not to activate the expander again until the new one came in. The expanders are made based on the molds that are taken. If I activate the expander, my jaw will not be the same as the mold. I was thinking that maybe we could just activate the new expander before putting it in my mouth. By that, I mean, say it takes 7 days for the new expander. Between now and then, I'd have done 7 activations. When I get my new expander, couldn't they just activate it 7 times and then put it in my mouth? The answer to this is NO, because the teeth don't only move outwards, they move side to side as well.

It turns out this won't be a big deal. My orthodontist made some calls and the new expander will be ready tomorrow morning. I'm going in at 9:00am to take this old expander off once and for all and replace it with a new one. After that point, I'll have approximately 15 more activations to go.

My orthodontist is a grad student at the University named Dr. Joanie Roy. I'm going to devote a whole post to her work soon enough. But quickly, I know she's going to be a great orthodontist! Her work is still reviewed by the attending orthodontist, who I think is Dr. Metaxas (the first orthodontist I saw about a year ago now!). Since she's a student, they have summer break for July and August. Since my activations will be over mid-June, I was booked in for JUNE 17 IN WHICH MY BRACES WILL BE PUT ON!! Joanie told me that since my teeth are so crowded anyways, she wouldn't need to see me for the first 10-12 weeks after putting braces on for the first time. This period would span her summer break, so the timing works out terrifically! So June 17 is going to be a big day!

Before I sign off, I asked Joanie about the numbness in the jaw. She said in her experience, there seems to be a "rule of 6". By this, she meant that the numbness in a patient's jaw ceases after 6 days, 6 weeks, or 6 months post-SARPE. I'm already past 6 days obviously, and am coming up on 6 weeks with no feeling yet. If I don't have feeling in the next couple of weeks, I guess I had better get used to not having it for some time.

My next update will be after the braces are put on June 17! Bye!

Tuesday, May 26, 2009

Picture Post #5 - 29 Activations

I dropped the ball with these pictures. I was trying to take some photos every 7 days following the SARPE surgery. Unfortunately, I forgot until a few days later on this week. These pictures were taken on May 23, 2009. Look at that crossbite!!!!!!

I added one picture of the roof of my mouth to compare it with when we started (see Picture Post #1). I think the differences are easily apparent. My palate is much wider now. Once the activations stop and the teeth begin shifting, this should given that nice rounded arch look, although this palate definitely seems rounder than the U shape I started out with.





Picture Post #4 - 19 Activations

As promised, the crossbite in this picture is much more apparent. It's almost as if the jaw is only expanding on that one side! These were taken on May 13, 2009.




Picture Post #3 - 12 Activations

These pictures were taken on May 7, 2009 - 8 days after activations at home started. So in total, I was at 12 activations on this day (8 + 4 in operating room). Notice how the space is bigger, and my crossbite becomes more apparent (if it's not apparent, it will be!!)









Picture Post #2 - Recovery

These next few shots are of me as the "chipmunk" described in an earlier post. The first picture was taken on April 29 - 6 days post-op. The last two were taken April 25, and the first picture a few days later. I apologize for the blood under my nose. If you've read this blog, you'll know that I had a hell-of-a-time with the nose bleeding. It didn't stop for about 4-5 days.







Clearly, I am swollen. Once the swelling started to recede, the bruising began. I also want to point out that all 4 of my wisdom teeth were pulled during the same operation, and so it's difficult to say how much swelling is from SARPE and how much is from the wisdom teeth. The first picture clearly shows some receding in swelling, but the bruising became much more apparent.
Also, notice how there is already a space between my teeth in pictures 2 and 3! I had not started activations on my own before this point, so this space is completely attributable to the activations done in the OR.

Picture Post #1 - Prior to SARPE

I wanted to FINALLY post some pictures for those of you thinking about going through the SARPE procedure.

This first set of pictures was taken on the night of April 22, 2009 - the night prior to my SARPE surgery.






























These are a small variety of photos taken the night prior to the SARPE surgery. I guess there are 2 things to notice: My teeth are terrible and my upper jaw is NARROW. This was back when my thumb could not fit between the two sides of the upper jaw. There's no real curvature to that upper jaw either, it looks more like the letter U (i.e. very straight sides) than a nice rounded arch.

Friday, May 22, 2009

28 Activations Done!

One day at a time. I just finished my 28th activation, hopefully leaving me with only 20 to go.

I forgot one important question from last time some of you considering SARPE may be thinking:

4. So what has eating been like?
In a word, uncomfortable. Eating was impossible for me for the first week. Nothing but liquids fed through a syringe. By the end of the first week, I was having soups, one of which was a homemade meatball soup with the meatballs all broken up into tiny pieces allowing me to have some protein from the meat.

The soups soon turned into soft foods. By the end of the 2nd week, I was having spaghetti and tomato sauce cut up very small so that chewing was at a minimum. Basically, anything that didn't require much chewing was edible.

Although I am able to eat most foods now, it is still painful on my front teeth to bite down on anything. I have to use my molars for all chewing purposes, and even with my molars, chewing is by no means as easy as it was before surgery. My upper jaw is still completely numb, so I'm sure this has something to do with it. Yesterday, I think I ate my most solid food of all so far - a plate of nachos! Sometimes, you just say to yourself that any pain caused by the chewing is worth it. Last night, it was definitely worth it!

Moral of the story is that the eating does come back little by little. It should not be your make-it-or-break-it concern, but be prepared for not being able to eat some of your favourite solid foods for a while! Again, I'm happy to answer any questions you may have.


I'll update again next week after I take the moulds for my new expander.

Wednesday, May 20, 2009

25 Activations Done!

We are now past the half-way point. 25 activations done, hopefully only 23 to go. The space between the front teeth is definitely well-defined now, and I can't believe it's going to get twice as big. Still no pain, and still no feeling in my teeth. The swelling has completely receded from the surgery, although I'm told that the entire roof of my mouth is white - I guess because it's all still healing.

There were a few things I was wondering going into the activations that I think I can clear up:

1. Do the expansions hurt?
The answer to this is NO (so far!). I definitely feel some outward-pushing pressure on my teeth when Lauren turns the key, but it's definitely not painful. How could it be? All the nerves are severed, and my upper jaw is separated down the palatal suture. I have heard that if you are a child, and therefore do not require the surgery, it can be uncomfortable because I guess the upper jaw isn't completely separated like those of SARPE surgery people.

2. What is the healing time for the SARPE surgery?
SARPE is an outpatient procedure. They kept me overnight only because my operation was done at around 5:00pm. I was discharged the very next morning. The first few days sucked: Did not get much sleep, nose kept bleeding, meals consisted of Boost through a syringe. Having said that, the pain was kept in check from the painkillers, and honestly, it was quite nice to just lie down on the couch and watch a bunch of DVD's all day long. And after the first few days, the major swelling in the face came down, the bleeding stopped, and 8 days later, I was off the painkillers completely. I took a total of 5 working days off, buit have heard that 2 full weeks is pretty common.

3. Did my facial structure change?
I couldn't believe that my facial shape wouldn't change, but it hasn't (again, so far!). The facial changes will happen during the next operation. I had also heard that SARPE could widen the base of the nose. I don't think this has happened to me. I think my nose is the same size as it was prior to the surgery.


Anyways, drop me a line if you'd like answers to anything else or more clarification on anything. I am seeing the orthodontist in a week to make the moulds for the new expander. Not looking forward to it, but it's gotta happen. I also called to make sure that the new appliance would be ready by the time I hit my maximum expansion with this appliance. I was assured this would be the case, so feel somewhat better.

Have a great week!

Thursday, May 14, 2009

19 activations done!

So I saw the orthodontist yesterday for the first time in two weeks. She said that everything was coming along nicely. She took some measurements to ensure that the observed width of the palate is consistent with what was expected by this point. I also found out that my surgeons performed 4 activations in the OR (=1mm), and so my total thus far is 19, or 4.75mm.

It is tough to say how many more I'll have. Initially, they said 12mm, which would be 48 activations, but who knows? Maybe I'll need more, maybe a little less. It all depends on the teeth.

The appt with the ortho in 2 weeks time will be uncomfortable to say the least. They will be taking my impressions in order to create a new expander with a longer screw. This means they'll have to take my current expander out, take the impressions, then put my current expander back in. In one week from that time, my new expander will be ready and I'll be nearing the maximum expansion with my current expander, so I'll go back in to take my current expander out (again) and replace it with the new expander. Fun fun fun.

I am slightly concerned about the new expander. What if it's not ready by the time I reach the maximum expansion? I'd be kind of screwed (excuse the pun!). I only have 22 possible activations left with this expander. I think the issue is that if you're not expanding every day, then the bone starts to heal which is something we don't want until the expansion is complete.

I think I'm going to call my ortho today just to make sure that the timing will all work out.

Will keep you posted!

Monday, May 11, 2009

Note the date and the time

I noticed something with my palate today. I think I mentioned before that my palate was so narrow that I could not touch the roof of my mouth with my thumb without touching both sides of my upper jaw.

No longer!

My palate is now wide enough to accomodate my thumb. This "thumb test" is my personal litmus test to see how narrow my palate really is. So don't worry, I am not planning on becoming a thumb-sucker at 26 years old!

Today marks activation #13. So I've completed 3mm of expansion - 25% of the way there (probably a little more than 25% actually since the surgeons did some expansions in the OR during the SARPE operation). I am seeing the orthodontist on Wednesday. We're going to have a look at how things are progressing, which includes the state of my gums - the periodontist was slightly concerned before the operation. Pretty soon, we'll also have to start talking about this second appliance which will be replacing the first one eventually in order to achieve the additional expansion my jaw needs.

Take care!

Wednesday, May 6, 2009

7 activations down, 41 to go

So today marks activation #8, which means I'll be at a full 2mm. The gap is definitely increasingly noticable.

I thought to myself, "Man, if only I had to go the 'typical' 6 or 7 mm! I'd be one-third done today!" Instead though, I'm only one-sixth done and have to wait another week until I'm at one-third. This gap is going to get up to 6x bigger!!! Ugh.

I saw the surgeon yesterday for a check-up, and he said everything was progressing nicely. My swelling is almost gone and I'm off of the painkillers (save 1 or 2 Advil's / day). The only thing left is to get some feeling back. My upper jaw is still numb.

I also had some FOOD last night. Granted, it was spaghetti cut up into some very small pieces with plain tomato sauce (allowing me to be able to swallow it with minimal chewing), but it was FOOD damnit!! I think I'm going to slowly be working pastas into my diet. Hopefully in a couple of weeks I'll be able to have some more solid foods.

That's it for today. I will follow up again with this blog next week when 14 activations have been completed. I will be seeing my orthodontist next Wednesday - I will also update everyone on that appointment.

Take care!

Monday, May 4, 2009

Weight Loss

Hi again,

Just a quick post on the weight loss.

I knew I had lost some weight, but I don't have a scale, so I wasn't sure exactly how much....until this past weekend. I went home for my brother's birthday, and weighed myself on my mom and dad's scale - they have one of the electronic ones.

I have lost 25 pounds so far! But since I'm 6'7", I am heavier than the average person. So the 25 pounds of loss only accounts for about 10% of my starting weight.

There will obviously be some rebound after I start eating again, but I'm hoping to keep a good portion of it off by slowly developing into a low-impact workout regimen. I'm headed home again this weekend for my sister's confirmation, and will see what the scale says this time!

As for the eating, the softer foods are starting to go down easier and easier. Oatmeal for breakfast, and soup for lunch/dinner is basically my diet right now. Am trying mashed potatoes as well.

Today marks activation #6. I'm starting to definitely notice the growing gap. There's no "pain" when the device is activated, but I can feel the pressure being put on my teeth, which is a very uncomfortable feeling!!

Until next time!