Thursday, August 28, 2003
What's Happening With My Mouth Now
Tomorrow will be six weeks post-op. While the swelling has gone down a lot in the past week and I have gotten some feeling back, I'm still swollen and numb. Last Wednesday, I woke up with some feeling back in my nose, and I felt tingling for about four seconds in my upper lip. While my swelling now is almost unrecognizable by looking in the mirror, I can feel it under my skin, especially when I wash my face. I have feeling back in my skin (except for my upper lip), but it is still numb and swollen underneath. My nose is sore. I have also been exercising my upper lip, and it is slowly starting to feel a little more normal, but I still have a long ways to go. The upper gums are still completely 100% numb. My front upper teeth are still sore.
Visit With Dr. Karlis on Tuesday
I went to see Dr. Karlis on Tuesday morning, to follow up after the course of antibiotics she gave me to combat the episode of post-surgery swelling that I experienced. She examined me, feeling the surgery site with her gloved fingers. I'm still tender there. She says I am doing well, and again she promised me that the feeling will come back. She wants to see me the week after my next appointment with Dr. Weston on the 11th, and she says she expects that will conclude my visits with her.
The Gap Narrows
Over the past weekend, the gap between my two front teeth began to close up. It closed rather quickly too. It seemed that every time I looked in the mirror, the gap had gotten narrower. Dr. Hahn told me that this would happen, but I did not think it would be this soon or so sudden. Apparently as the bone generates in the area, this movement will continue. Perhaps those daily protein shakes from The Pump are helping.
Bill From NYU
I got my bill from NYU Medical Center this week, for $392.41. This is for the rest of what I owe in operating room/hospital expenses for the surgery after the insurance company paid. It's about $100 less than I was expeccting. Dr. Karlis billed and got paid by the insurance company separately.
Eating
I'm still having difficulty eating. Since my molars no longer fit together and I am afraid I am going to break my teeth if I bite down hard, chewing anything with more consistency than soft pasta or bananas is pretty much out of the question. I can manage ground beef in lasagna or meatballs, or chicken in soup if it is very well-cooked and comes apart easily. But anything tougher than that is out of the question.
Tooth Brushing Ritual
My nightly tooth brushing routine has become quite a ritual for me. I brush my teeth three times with three different toothbrushes, flossing after the first and third brushings, followed by a warm saltwater rinse. If I have had coffee that day, I use baking soda for the second brushing. In the morning, I brush once in the shower. I should probably brush once after lunch; I'll have to work on that.
Looking Forward to the Braces
I'm looking forward to getting my braces and getting on with my course of treatment. I hope that Dr. Weston can put them on soon. I still have not decided upon metal or clear for the upstairs teeth. The right front band is a little low. I can feel metal protruding down a fraction of a millimiter. I will have to remember to ask Dr. Weston to fix that when the expander comes out.
Tomorrow will be six weeks post-op. While the swelling has gone down a lot in the past week and I have gotten some feeling back, I'm still swollen and numb. Last Wednesday, I woke up with some feeling back in my nose, and I felt tingling for about four seconds in my upper lip. While my swelling now is almost unrecognizable by looking in the mirror, I can feel it under my skin, especially when I wash my face. I have feeling back in my skin (except for my upper lip), but it is still numb and swollen underneath. My nose is sore. I have also been exercising my upper lip, and it is slowly starting to feel a little more normal, but I still have a long ways to go. The upper gums are still completely 100% numb. My front upper teeth are still sore.
Visit With Dr. Karlis on Tuesday
I went to see Dr. Karlis on Tuesday morning, to follow up after the course of antibiotics she gave me to combat the episode of post-surgery swelling that I experienced. She examined me, feeling the surgery site with her gloved fingers. I'm still tender there. She says I am doing well, and again she promised me that the feeling will come back. She wants to see me the week after my next appointment with Dr. Weston on the 11th, and she says she expects that will conclude my visits with her.
The Gap Narrows
Over the past weekend, the gap between my two front teeth began to close up. It closed rather quickly too. It seemed that every time I looked in the mirror, the gap had gotten narrower. Dr. Hahn told me that this would happen, but I did not think it would be this soon or so sudden. Apparently as the bone generates in the area, this movement will continue. Perhaps those daily protein shakes from The Pump are helping.
Bill From NYU
I got my bill from NYU Medical Center this week, for $392.41. This is for the rest of what I owe in operating room/hospital expenses for the surgery after the insurance company paid. It's about $100 less than I was expeccting. Dr. Karlis billed and got paid by the insurance company separately.
Eating
I'm still having difficulty eating. Since my molars no longer fit together and I am afraid I am going to break my teeth if I bite down hard, chewing anything with more consistency than soft pasta or bananas is pretty much out of the question. I can manage ground beef in lasagna or meatballs, or chicken in soup if it is very well-cooked and comes apart easily. But anything tougher than that is out of the question.
Tooth Brushing Ritual
My nightly tooth brushing routine has become quite a ritual for me. I brush my teeth three times with three different toothbrushes, flossing after the first and third brushings, followed by a warm saltwater rinse. If I have had coffee that day, I use baking soda for the second brushing. In the morning, I brush once in the shower. I should probably brush once after lunch; I'll have to work on that.
Looking Forward to the Braces
I'm looking forward to getting my braces and getting on with my course of treatment. I hope that Dr. Weston can put them on soon. I still have not decided upon metal or clear for the upstairs teeth. The right front band is a little low. I can feel metal protruding down a fraction of a millimiter. I will have to remember to ask Dr. Weston to fix that when the expander comes out.
Saturday, August 16, 2003
More Swelling
On Wednesday morning I woke up with a lot more swelling, especially on the left side of my face. When I got to work, my boss noticed this increased swelling and suggested I call my doctor. I emailed Dr. Karlis about it, and she had me come in first thing Thursday morning. When I got there the next day, I was still more swollen than usual. She took a panoramic X-ray, and we looked at it together. She didn't find anything bad, except for the final wisdom tooth I have on the upper left. She said it might be that. Or it could be an infection, or sinusitis. She was thinking of cutting inside my mouth to drain some of the fluid accululating in my face, but decided to let the antibiotic take effect first. She put me on a strong antibiotic, amoxicillin, told me to call her the following morning, and sent me on my way. She also introduced me to Dr. Glickman, who will be covering for her next week while she is out of town.
The Blackout
The blackout struck at 4:11 pm Thursday, so in addition to dealing with the increased swelling and uncomfortableness, there was also the heat and darkness. I got by on soup for the 27 hours that the power was out. I spoke with Dr. Karlis on Friday morning and today (Saturday). I can't tell whether the swelling is going down that much. I am definitely not getting any worse. I'll check in with her again mid-week, or sooner if I get worse.
Almost One Month Ago
Monday will be one month after surgery, or "post-op" as they say. I'm still numb, and my upper lip still feels tight and puffy. Also, probably the most disturbing thing is that my back teeth no longer fit together properly. Instead of closing at the top, flat surfaces, they are closing at a bad angle, so it's nearly impossible to chew anything normally.
On Wednesday morning I woke up with a lot more swelling, especially on the left side of my face. When I got to work, my boss noticed this increased swelling and suggested I call my doctor. I emailed Dr. Karlis about it, and she had me come in first thing Thursday morning. When I got there the next day, I was still more swollen than usual. She took a panoramic X-ray, and we looked at it together. She didn't find anything bad, except for the final wisdom tooth I have on the upper left. She said it might be that. Or it could be an infection, or sinusitis. She was thinking of cutting inside my mouth to drain some of the fluid accululating in my face, but decided to let the antibiotic take effect first. She put me on a strong antibiotic, amoxicillin, told me to call her the following morning, and sent me on my way. She also introduced me to Dr. Glickman, who will be covering for her next week while she is out of town.
The Blackout
The blackout struck at 4:11 pm Thursday, so in addition to dealing with the increased swelling and uncomfortableness, there was also the heat and darkness. I got by on soup for the 27 hours that the power was out. I spoke with Dr. Karlis on Friday morning and today (Saturday). I can't tell whether the swelling is going down that much. I am definitely not getting any worse. I'll check in with her again mid-week, or sooner if I get worse.
Almost One Month Ago
Monday will be one month after surgery, or "post-op" as they say. I'm still numb, and my upper lip still feels tight and puffy. Also, probably the most disturbing thing is that my back teeth no longer fit together properly. Instead of closing at the top, flat surfaces, they are closing at a bad angle, so it's nearly impossible to chew anything normally.
Thursday, August 07, 2003
Visit Today With Dr. Weston, Dr. Hahn and Dr. Karlis
I had a visit today at NYU Orthodontics. It has been three weeks since the surgery, and three days since my final activating turn on the expander. Dr. Weston and Dr. Hahn both examined my mouth and both told me they were pleased with the expansion. Dr. Weston said that with all this new real estate in my mouth, that he will be able to do everything he needs to do to create my brilliant smile. After looking at me, Dr. Hahn said his call last week to have me turn the device five more times was the correct decision. He said that while my situation is not perfect, that everything will be able to be corrected. I had several questions for them, and they took their time explaining things to me. Two of Dr. Weston's colleagues looked at me today as well. Dr. Weston said that he had been bragging to them about my treatment. Dr. Karlis also came up to see me, and again we had our conversation about the numbness in which she promised me that it will go away eventually. She says probably in the six- to eight-week period. Also today I had some good (and really, really good) news and some bad news.
First, the Good:
The good news today is that the doctors are happy with the expansion and that I don't have to crank the expander anymore. Dr. Weston even added a wire to the device today to "lock" it in place for good. The really, really good news is that they might be able to save the lower front tooth and not pull that one after all. I cannot even begin to say what a relief it will be to me if I do not have to have that tooth pulled. To begin with, I cannot bear to have a tooth pulled, and even more importantly, keeping the tooth will also allow me to retain my center line.
Now, the Bad:
The bad news, from Dr. Hahn, is that the expander might have to remain cemented in my mouth for up to SIX more months! Yikes! He said "three to six months." I was not prepared for that long a stretch of time. It's important that the bone grows and heals and solidifies before the device is removed, so I am happy to be wired with it. But six months is going to get me into 2004, and I have at least a year of braces afterward, and I am eager to get on with things.
The Incision
I haven't written much about my incision. It runs inside the front of my mouth, above my upper teeth, between the first premolars on either side. About two and a half to three inches. I had resorbable stitches, and the area has been sore, stiff and numb. I have been rinsing at least once a day with warm salt water, but I have only looked up there two or three times. It's just too gross and unsettling for me to deal with. Well today, after the examination in Orthodontics, Dr. Karlis brought me down to the Oral Surgery Department and removed what was left of the stitches. This was a painful, difficult procedure, but it was over in a jiffy and I was happy to be on my way.
I go back to see Dr. Weston in one month, and Dr. Karlis a week after that.
I had a visit today at NYU Orthodontics. It has been three weeks since the surgery, and three days since my final activating turn on the expander. Dr. Weston and Dr. Hahn both examined my mouth and both told me they were pleased with the expansion. Dr. Weston said that with all this new real estate in my mouth, that he will be able to do everything he needs to do to create my brilliant smile. After looking at me, Dr. Hahn said his call last week to have me turn the device five more times was the correct decision. He said that while my situation is not perfect, that everything will be able to be corrected. I had several questions for them, and they took their time explaining things to me. Two of Dr. Weston's colleagues looked at me today as well. Dr. Weston said that he had been bragging to them about my treatment. Dr. Karlis also came up to see me, and again we had our conversation about the numbness in which she promised me that it will go away eventually. She says probably in the six- to eight-week period. Also today I had some good (and really, really good) news and some bad news.
First, the Good:
The good news today is that the doctors are happy with the expansion and that I don't have to crank the expander anymore. Dr. Weston even added a wire to the device today to "lock" it in place for good. The really, really good news is that they might be able to save the lower front tooth and not pull that one after all. I cannot even begin to say what a relief it will be to me if I do not have to have that tooth pulled. To begin with, I cannot bear to have a tooth pulled, and even more importantly, keeping the tooth will also allow me to retain my center line.
Now, the Bad:
The bad news, from Dr. Hahn, is that the expander might have to remain cemented in my mouth for up to SIX more months! Yikes! He said "three to six months." I was not prepared for that long a stretch of time. It's important that the bone grows and heals and solidifies before the device is removed, so I am happy to be wired with it. But six months is going to get me into 2004, and I have at least a year of braces afterward, and I am eager to get on with things.
The Incision
I haven't written much about my incision. It runs inside the front of my mouth, above my upper teeth, between the first premolars on either side. About two and a half to three inches. I had resorbable stitches, and the area has been sore, stiff and numb. I have been rinsing at least once a day with warm salt water, but I have only looked up there two or three times. It's just too gross and unsettling for me to deal with. Well today, after the examination in Orthodontics, Dr. Karlis brought me down to the Oral Surgery Department and removed what was left of the stitches. This was a painful, difficult procedure, but it was over in a jiffy and I was happy to be on my way.
I go back to see Dr. Weston in one month, and Dr. Karlis a week after that.
Wednesday, August 06, 2003
List of Woes
I am miserable in so many different ways. In addition to the pain, numbness and swelling, I also have headaches. All of my upper teeth are sore, making tooth brushing, flossing and chewing of any kind painful. I have difficulty speaking with the expander cemented into my mouth. I have had strange sensations on my upper lip. I often feel like my nose is dripping, when it is completely dry. (Other times I have the same feeling and my nose actually is dripping!) The roof of my mouth is tender. My upper gums are completely numb. I can't eat normal food. It's been yogurt, applesauce, cottage cheese, soup, scrambled eggs, ice cream, and protein shakes. I can also manage tuna fish and lasagna (cut up with a knife and fork). When this is all over I will have a much greater appreciation for things like apples, pizza, burgers, tortilla chips, bagels, even sandwiches and chicken!
Final Crank on Monday Night
On Monday night I performed the 19th and final crank (or "activating turn" as they say) on the expander device. I was hoping that I would wake up this morning (Wednesday) with much less pain, swelling and numbness, but I had no such luck. Hopefully I will make much more progress over the next few days and weeks.
I Had Nosebleeds After Surgery
I think I forgot to write in this journal that on the day of and the day after surgery, in addition to everything else, I had several nosebleeds.
It's Called a 'SARPE'
Dr. Weston tells me that the name for the procedure I am going through is a SARPE, or Surgically Assisted Rapid Palate Expansion. I have also seen it described as a SAME, or Surgically Assisted Maxillary Expansion. I did some research this week on the internet and found some sites describing the surgery and procedure (with some rather graphic pictures) and also some discussion groups for people who have had jaw surgery like and similar to mine. After reading some of these accounts, I feel lucky by comparison. Many people have BOTH jaws operated on, or they have their jaws lengthened or shortened. Ouch! Also, many people have to have their jaws wired shut for weeks. I investigated these sites to find out about the numbness, which continnues to be my greatest source for concern and worry. Many people online have reported numbness that lasts for months and months. My doctors, whom I have full faith and confidence in, promise me that my numbness will go away, but I am still nervous about it.
I am miserable in so many different ways. In addition to the pain, numbness and swelling, I also have headaches. All of my upper teeth are sore, making tooth brushing, flossing and chewing of any kind painful. I have difficulty speaking with the expander cemented into my mouth. I have had strange sensations on my upper lip. I often feel like my nose is dripping, when it is completely dry. (Other times I have the same feeling and my nose actually is dripping!) The roof of my mouth is tender. My upper gums are completely numb. I can't eat normal food. It's been yogurt, applesauce, cottage cheese, soup, scrambled eggs, ice cream, and protein shakes. I can also manage tuna fish and lasagna (cut up with a knife and fork). When this is all over I will have a much greater appreciation for things like apples, pizza, burgers, tortilla chips, bagels, even sandwiches and chicken!
Final Crank on Monday Night
On Monday night I performed the 19th and final crank (or "activating turn" as they say) on the expander device. I was hoping that I would wake up this morning (Wednesday) with much less pain, swelling and numbness, but I had no such luck. Hopefully I will make much more progress over the next few days and weeks.
I Had Nosebleeds After Surgery
I think I forgot to write in this journal that on the day of and the day after surgery, in addition to everything else, I had several nosebleeds.
It's Called a 'SARPE'
Dr. Weston tells me that the name for the procedure I am going through is a SARPE, or Surgically Assisted Rapid Palate Expansion. I have also seen it described as a SAME, or Surgically Assisted Maxillary Expansion. I did some research this week on the internet and found some sites describing the surgery and procedure (with some rather graphic pictures) and also some discussion groups for people who have had jaw surgery like and similar to mine. After reading some of these accounts, I feel lucky by comparison. Many people have BOTH jaws operated on, or they have their jaws lengthened or shortened. Ouch! Also, many people have to have their jaws wired shut for weeks. I investigated these sites to find out about the numbness, which continnues to be my greatest source for concern and worry. Many people online have reported numbness that lasts for months and months. My doctors, whom I have full faith and confidence in, promise me that my numbness will go away, but I am still nervous about it.
