Well, Here I Am

Not too bad hunh? Pretty amazing stuff. One thing I noticed going into this is no matter what, nobody comes out looking worse than they did before. Definitely different, but always better. There are still details about my smile that I don't like but will probably not be fixed at this point, but frankly, I'm sure no one else sees them but me. That's what happens when you obsess over a part of yourself for three years. But for now, no more exciting appointments until after the New Year.

Until then, from the most sincere part of me, relax, be safe, enjoy the company of those you love, and have a wonderful holiday season. Love to all.

Daily Reading

http://www.nytimes.com/2009/11/17/health/17brod.html

Might be particularly interesting for the older crowd with bridges.

Implantified

Yesterday went really well. As well as I could have ever hoped. When I was 16 sitting in the waiting room to have what was left of my #30 tooth removed I remember looking through the pamphlet of what implants entailed and had a bit of a panic attack. I didn't have much time to think about the whole process as it was kind of an emergency extraction and seeing little illustrated pictures of metal posts sticking out of people's gums made me queasy. Maybe I've just gotten used to dental surgery. I went in, tried to relax a bit, and once The Chainsaw showed up they put a little nitrous oxide over my nose and a tiny needle in my arm and before you could say blueberry pie I was back to and texting my friends and family. Looking back through my Sent Messages apparently I REALLY liked the feeling of the nitrous. Who could blame me? It's fun! I did pass out in the wheelchair on the way to the car, I think it was a combination of the nitrous and thinking I could talk and stand up and everything way before I should. Definitely need a driver if you're having this done! But once I was able to nap it off and drink some soup I felt like I was good to go around 2pm. I got a little healing cap over it so they didn't put the flap of gum back over the implant like I thought they would.

It's not so bad, just a little more hardware :)

Won't Be a Pearly White Christmas

So I got the Super-dee-duper green light about the space for the implant yesterday along with a new rubberband orientation. My bite gets closer and closer with every change so that's nice to see. I'm on for the implantation Thursday morning, got my ride all sorted, but The Chainsaw never mentioned anything about pain killers for afterwards. I think I'm gonna call and check on that today. My next ortho appointment is scheduled for (unfortunately) after the new year. So no debracing for Christmas. *shrug* I wasn't really expecting it to happen. I'm hoping I'll be able to take the day off work Thursday (the procedure is at 9am), rest up, and get back to work on Friday.

Anyone think I'm crazy?

Worst Blogger Ever

Anyone else notice how after people have their surgery they kind of fall off the face of the planet? Yeah, it's weird. So much has happened, but not really. I guess everything has just gotten back to normal, and that's why it seems so un-noteworthy. Let's see, it's been about 3.5 months since the date. I'm eating completely normally. No more physical therapy (25+ sticks.) wearing "tweaking" rubberbands that I can still talk normally with. Even playing hockey again (I didn't tell The Chainsaw yet, shhhhh.) I haven't weighed myself since the surgery because I haven't gotten myself back to the gym yet, work is my excuse right now but that will change in a couple weeks. Oh and I have a date for my implant to be, well, implanted. November 12th. It would have been four months to the day after the surgery but I have a game that night so I pushed it back one :) I do have new pics to show. Crap. Old pics to show from post-op too! They're on my laptop and I blah blah blah lame lame lame. Anyway, I've gotten the obligatory "I didn't recognize you"s and the "you look way better"s and everything. And I'm happy too. Chewing into food for real is definitely something I will never take for granted. Oh, another tiny little victory I savor is being able to tear tape with my teeth at work. Always envied that. So I see my ortho on the 9th to double-triple-check the space for the implant is perfect (it's been a disconcerting nightmare getting my ortho, dentist, and OS on the same page about this for some reason) and then if I've been good there's a glimmer of a chance I might get the braces off before Christmas...



...which is ortho speak for St.Paddy's Day. So we'll see ;)

PT Checkup

Went in yesterday and The Chainsaw seemed impressed. Two weeks ago I left his office maxing out at 17 tongue depressors and now I'm up to 21. There are only 25 in the stack he gave me. That equals about 40mm which is supposedly an average opening for an adult. He asked if I wanted his help getting the last four out of the way and naturally I respectfully declined. I like the pace I'm going at on my own thank you very much. I go back in in four weeks and should have the whole stack taken care of without a doubt. By then the bone graft should be pretty well healed and we'll discuss getting the implant, well, implanted. So it was a good day. I'm starting to feel recovered. Eating is pretty much normal now and I'm giddy when I can cut through food with my front teeth. Swelling I think is all gone, still a little numbness but nothing distracting. And if I wasn't so involved with my car right now (stripping/rebuilding engine/restoring my '66 mustang) I'd be back to playing hockey. Still no pictures posted though because I'm a little lazy, and I need a haircut terribly.

Short Lived

Well it didn't last long but this is what the Wiki said,

"Zip-N-Squeeze is a company that makes bags for drinking food post jaw surgery. Despite being well known, they are a fraudulent company and should not be supported."

Wiki

http://en.wikipedia.org/wiki/Zip-N-Squeeze

Ha. Take that. Bastards.

Hope

Okay, I over reacted. Things are getting better. I can reach my tongue depressor goal with less and less pain every day. Everything is ok.

That first day really hurt though! *shrug*

Crybaby

This morning I saw The Chainsaw. He took off the rubberbands (as promised) and began to torture me (as promised.) And after my short jaunt into I-want-to-curl-up-into-a-ball-and-escape-this-world-Land I brushed my teeth and was ready to go. Free of elastic tyranny. With a couple hours to kill before my appointment with Dr.Styrt I thought breakfast from a plate instead of a cup would be a wonderful idea. Buckwheat pancakes and scrambled eggs for me, thank you. It was delicious. I had to take it slow though. Little pieces, little bites. I realized I wouldn't be eating a cheeseburger just yet today.
Everyone at the ortho office was happy to see me and loved the results so far. They brought up my initial exam photos for a quick comparison and it's pretty stunning. My tech Kira snipped the surgical hooks off and before I knew it I was banded shut again.

Wait, what? Crap.

I knew they'd be putting rubberbands on again but I thought I'd be able to open my mouth with them on. No such luck. But at least I can take them off to eat and brush and perform what feels like and oral equivalent of hari kari. Which brings me to my main topic for the day.

Physical Therapy hurts. It hurts a lot. Do not be fooled. I don't know why it seems like no one mentions this part in their blogs. Have I not been paying attention? I'd like to think I'm a pretty tough guy but I dunno. Seventeen tongue depressors later and I'm a weeping twit. Seriously. It's a rare day on earth that I shed a tear, but this is the most painful thing I've ever endured. I thought it would get better by talking and eating and yawning without the elastic restraints, but that thought went out the window with the new rubberbands today. I see the Chainsaw in two weeks. We'll have to see how things pan out.

Last Night

I dreamt I was eating a giant plate of nachos.

Tomorrow these dreaded rubberbands come off!

Fuck Zip-N-Squeeze

Long story short, I'm stubborn and didn't think I'd need Zip-n-squeeze bags. I figured the hospital would provide me with anything I needed. The problem with the syringes they give you is they can't handle anything even moderately chunky. The hole is just too small for anything but actual liquid. So I order a 4-banger of the large food oriented bags. They haven't shown up yet. So I called yesterday for a refund, no biggie. Well yesterday their voicemail was full. Today the number has been disconnected. And their email through which I sent my payment, defunct. So please excuse my language but after all this I just don't have the decorum to hold back.

Fuck them.

Fuck them right in the ear.

Clarification

Oh yeah. Just to be clear, my jaw is still immobilized with the rubberbands. So I can't "practice" stretching in between visits. So I'm not sure how I'm supposed to "progress" to get to three fingers. It seems like my surgeon has some sort of hyper-advanced super-quick path of rehabilitation.

Ouchy

Ever since about the middle of Week 2 any complaints of pain came from the muscles (the masseter, actually) being all tight and not being able to strech out. The bone break has long since felt fine. This morning seems to be particularly bad for some reason. Must be because of yesterdays appointment with The Chainsaw. Before I got to brush, he wanted to do a little stretching. He told me to open up enough to put my index finger between my teeth. Seems easy enough, I could just barely do it. Then he told me to rotate my finger 90 degrees. Hmm, ok, took a second but I got it. Then he told me to put two fingers between my teeth and rotate them. I could turn them maybe 45 degrees and I was cheating by letting them slide around each other instead of keeping them directly side by side. Well, I think The Chainsaw was busy this particular morning because after my weak attempt he decided to do it himself. Donning a blue latex glove he placed his hand ever so gentl....WHAM! and twisted! And as I whimpered like a little girl, writhing around like a spider had been held in front of her face with nowhere to go, he calmly held my jaw open for 30 seconds or so. It hurt pretty badly. Granted, before the surgery, he said the rehab would be very hard. I just expected something more gradual. Like a tiny vintage car jack that would ratchet my mouth open one tiny crank at a time. No such luck.

Next week he said we were aiming for three fingers. He suggested I pre-medicate with some advil. I'm thinking some of that leftover vicodin might do the trick.

Boston Creme Pie Shake Recipe

12 oz. Whole Milk
1/2 of an entire Boston Creme Pie

Blend.

Week 2 Checkup

Visited with The Chainsaw today (he was in an unusually "playful" mood today which was both comforting and strange at the same time.) He removed the rubberbands (somewhere between 15-20 of them?) and had me brush my teeth with my brand new baby toothbrush with little duckies on it. Though it was a bit uncomfortable being unbanded at first so I had to take my time. My jaw didn't fall open from lack of use like I had imagined. Quite the opposite. Using the muscles again to slowly open my mouth was like trying to benchpress an empty bar when you've never lifted before. It's not that it's too much weight, but the muscles aren't exactly sure what they're supposed to be doing so it's kinda shaky and awkward. But brushing is very nice. I know my breath was startin' to kick like Long Beach at low tide. A smile did creep over my face a couple times thinking about how cool it is that my teeth actually come together now. He put four bands back on the sides but the front is clear for me to stare at how nice my bite finally is. This will be our routine for the next four weeks, then physical therapy.
I've decided to go back to work next Monday. If things were dire I think I could have done at least half days after day 11 or so. But also know that talking isn't a huge part of my job. If it were, well, I would probably wait until week 4 or later. I can talk, it's just not clear, strong, or pretty.

What's Going On

Not a lot really. I'm off the pain meds and sleeping through the night now. A stitch came out the other day. My lips are still super tingly getting their feeling back and my right cheek is still pretty numb. Most people wouldn't be able to notice the little swelling that's left. I'm able to speak with minimal clarity but it's better than having to write everything down. I had lost about 10lbs @ 175 but I'm close to breaking 180 already. 185 is a normal weight for me. Two big bowls of soup and two calorie packed shakes a day are doing the trick. I'm coming up on the end of my second week off work and have two more to go but I might get some work to bring home this weekend. I go in for a follow-up on Monday whence I'm supposed to be able to brush my teeth once and have the gazillion rubber bands in mouth reduced to four or six. I'd really like to be able to open my mouth. I'm not sick of the blenderized food yet* but drinking through a syringe is very tedious.

*I discovered that blueberry muffins and two-day old glazed donuts blended in milk make an amazing breakfast treat.

Tsteeves Asks,

"Going to have double jaw surgery and genioplasty on August 10th. Not sure what I should be doing to prepare. Also had SARPE and don't recall really preparing for that at all...but am more apprehensive about this. Is there anything you realize now that you would've done differently in preparing?"
Well Tstsy, first of all let me say that it's hard for me to imagine how much harder a double surgery would be than this. In my "research" it seems clear that BSSO-ers have it way worse than Leforte-ees. Here's what I do know, about a month out from my SARPE I got jacked. Hitting the gym, eating well, eating LOTS, it was my mission. I put on almost 20 pounds of muscle, had great energy and a beaming outlook on the surgery to come. Now, having, growing, or defining your muscles (or any part of your body's picture) probably doesn't directly help at all. But what it did was make me feel damn near indestructible mentally. Sure, I took it easy afterwards and wasn't out benchpressing cars in between blended lunches, but I always had a really great feeling about the whole thing. This time I didn't do any of that. I'm not depressed or anything. Things are coming along really well and I still see great progress from day to day. I'm pretty sure I won't need 100% of the time off I've requested from work (shh, don't tell anyone) and I can already see an amazing result waiting for me under some swelling and bad skin. But since you asked, I would have gotten in great shape like last time were I forced to try again.
Now, that's just one of my things. I like going to the gym. I love setting goals for myself and reaching them (or missing them and self-motivating to reach them next time around.) Maybe your thing is a musical instrument, a visual art, a crossword puzzle, spending time with someone special, working on your house, whatever. My point is this:
Make yourself indestructible.

...it might not help at all. I might be full of it. But that's my tuppence for those still listening :)

One Week Passed

I'm feeling conflicted about what to post about the past couple days. I don't know if I want to rehash all the details of Day 1, Day 2, Day 3, etc., or if I just give an overall summary. Opinions? I'm sure most of you could guess from my lack of enthusiastic posting before this surgery that I didn't come in to it with a head full of steam. Partly because I had a lot of stuff going on just prior, and partly because I didn't feel it would be a huge deal since I had survived the SARPE (and pretty well I think.) In hindsight, I wish I had put my head down and barrelled in like I did before as far as putting on weight and eating well and exercising. Instead I just sort of moseyed in to major skull chopping.
I will say these few things in general:
-the pain is different than the SARPE. That was a burning kind of sensation along the entire upper lip line. This one is very sharp localized pain right underneath my ears. This must be where the bone was removed from the maxilla for the posterior impaction.
-On the one hand, it's nice to be able to keep the roof of my mouth wet and happy, on the other hand, it'd be nice to be able to do the same for my lips.
-It's hard work eating through a syringe. Way easier when you can open your mouth.

Overall, I feel like this one is definitely taking more out of me, but I can't be sure if it's because of the different procedure, or if I just wasn't ready like I should have been.

Breaking Radio Silence

Well I guess it's day 5. I think I hopped online at Day 4 last time. Oh well. I was trying to take a nap but couldn't sleep so I thought I'd just write a quick hello. Things are fine. Nose is clogged. Pain is dwindling. Having weird dreams about eating sticky foods like taffy and not being able to open my mouth. Ha! Didn't see that coming. Anyway, I might feel a little more author-y tomorrow. Thanks to all the well-wishers.

Pokey and Preppy

Got my surgical hooks on yesterday. Not as bad as everyone says. I mean, they're actually smaller than the canine hooks most people have on their brackets. I do feel more "dangerous" with them though. Like a gangsta! Or like an alien with big sharp teeth. Like Stitch (of Lilo and...) Anyway, I have a pre-op appointment with Dr.Tawfilis this afternoon, then dinner with my mom (who flew in for the weekend. Thanks Mom!) and family at Buca di Beppo. And tomorrow morning I have to be at the hospital by 5:30 am. Cripes, that's early. But, let's do it. Bring it on. You got nothin on me surgery woes.
I'll be taking pictures throughout again like the SARPE, but I think I'm going to borrow from Wired Lady's style and not post anything until I'm relatively less swollen so that everyone will be able to see the real impact of difference. Well it's a busy day so you probably won't hear from me for a couple days. Take it easy and send good healing vibes.

Shiney

Well here we go. I went in yesterday for a last minute cleaning and check-up. Everything went very well. Miko and I had a wonderful conversation about theatre around town and what's in NYC as well. Dr. Misleh gave me a thumbs up and everyone wished me luck for Saturday.
Only a couple days now and I'll get to sleep in for as long as I want. Who said jaw surgery was all bad?

Date II

July 11. One month away kids! I had an appt with Dr.Styrt today to check on the little adjustments he made last time and I figured I'd put a call in to Veronica @ The Chainsaw's office to see if she had any headway with the insurance. (Apparently they had not yet received the notifications that I had yet.) They still hadn't gotten them so I faxed over my copies. Sure enough, while I was in the chair having molds taken she called me back to confirm I was slated for the 11th. It couldn't be better timing. My show opens on the 28th. Then my girlfriend Kelly and I are going to Vegas for a few days. Then the 4th of July celebrations. Then a week to prepare myself before getting hacked apart. I've got a pre-op appt with The Chainsaw on the 10th and getting my hooks on with Dr.Styrt on the 9th. I'll see if I can't get in to see Dr.Misleh before that for one last grill detail before being banded shut for awhile.
Dr.Styrt made a remark about "being on the home stretch" today, but I really don't feel like that's the case. After the surgery I've still got at least 6 more months in wires, then all the stuff that goes with the implant, then getting my janky nose fixed up. (Not cosmetic, deviated septum.) So I'll be posting for at least another year or so I imagine. Don't put me in the archive folder yet.

Post Script-

AND!- My braces are all paid off! Whoohooo! That'll be a nice chunk of change every month to get back in my pocket.

Take That, Red Tape!

I scoff in the direction of retarded insurance policies designed to deter us from our medical goals! After a week of calling the ENT's office every day to see if anyone had cancelled so I could get in as early as possible (as opposed to waiting until July 18th, pssht) I came home after a day of late work to find two letters from my medical provider. Now, normally, these envelopes come about a week after I have seen my doctor and they're usually a questionnaire about how the service was and, normally, I throw them away because really who has the time? Well, the first of the two says, "Based upon information provided, Sharp-Rees-Stealy Medical Grp (sic) has approved a referral to the following: The Chainsaw, D.D.S., blah-blah-blah."
Sweet! I don't even have to go to the ENT! It's ridiculous that I'd have to waste his time and mine for him to look at me for the same thing again, seriously.
So I go on to the second envelope expecting it to be an accidental second copy of the first. It says, "This letter confirms that Sharp-Rees Stealy Medical Grp has been notified of a proposed treatment plan for you and has reviewed the plan for medical necessity and health plan coverage. The information obtained concerning the treatment plan indicates a hospital admission has been approved to the following: Leforte without* bone graft."
Yay! I didn't really have any worries about the surgery being covered because the first was handled without me ever seeing a shred of paperwork. My boys and girls in the offices are earning theirs for sure.
* I really do need, and am getting, a bone graft for my missing tooth/implant-to-be during my Leforte procedure, but I always knew it wouldn't be covered. But, by doing it at the same time, things like hospital stay and anesthesia will already be paid for. I did the same thing by having my wisdom teeth extracted during the SARPE. Just being efficient!
So it's great to get these letters. I'll set up an appointment to see The Chainsaw tomorrow morning and see how much steam we can get going here. In a perfect world, the first week of July would be best for surgery, but anytime before September can work.

Adjust

Went into Dr.Styrt's today. He and the Chainsaw had a conversation with my molds in hand and decided on one last adjustment before the big day. When that big day is, we have yet to learn. But it's nice to know that they are being proactive about things. It means that I've got four weeks to convince my ENT to see me ASAP so that by the time the teeth are where they want to be, the insurance approval is where I want it to be.
Like, in my back pocket. Sucka.

Ok, so,,,

...I apologize for the last post, especially when followed by a long period of silence. Not a very nice thing to do. Like telling someone that you know someone who has a crush on them but not spilling the beans.
To pick things up, when I posted it had been about six weeks (I think) since Dr.Styrt said I was ready for surgery...and nothing had happened. After that appointment (six weeks prior) I immediately called The Chainsaw to get an appointment. His receptionist Kim told me that she couldn't just make me an appointment, that my insurance had to approve the appointment. So I called my insurance and asked what I needed to do. [I was worried because I didn't want to go through the litany of referrals (from PCP to ENT to OS) in order to get there. Some of you might remember form the SARPE that this took about six months when it was all said and done because doctors schedules are pretty backed up. So despite that it's a simple 5 minute conversation in which I explain to the doctor what's going on and why I need the surgery, it can take months just to get in.] The nice girl on the other end of the phone said no it's no problem, I just have to have my ortho send a letter explaining the situation to so-and-so. Well great. I pass the info on to Dr.Styrt and they send the letter.
Wait.
Wait.
Wait.
Now we're six weeks later, nothing has happened, and I'm back at Dr.Styrts for an appointment that, had everything gone as planned I'd be getting my surgical hooks on. But alas, nothing has happened. So now we start backtracking and find out that HealthNet had declined the surgery. Lemme say dat agin, Declined the surgery. Not just an appointment. So after MUCH confusion and phone calls back and forth to/from Dr.Styrt and The Chainsaw's, we got it figured out. And while that sounds like good news...

I do in fact have to go back through the gauntlet of referrals to even get the appointment with my OS. Even though they've all already seen me for this process. The way I see it, this is just step 2 of what has already been approved. The way HealthNet sees it, new procedure, new approval.

So I've seen my PCP and have an appointment with my ENT on July 18. After a lot of (hopefully embarrassing) recounts of what this surgery is and why I need it and "you've already seen me for this"s, she said she would call the ENT directly to try to either get a verbal referral straight to the OS or at the very least, to squeeze me in sooner. I called her again yesterday to see where we were at with that and apparently the ENT was on vacation last week (good thing, so was I) but that she will check up again and get back to me on Monday.
I'm hoping we can get everything in line for me to be in a hospital bed about 7 weeks from now.

Omigod...

...insurance is maddening.

I would explain, but I don't even understand the mess that's going on.

Go Bananas!

I am so happy. I went to GNC last night to restock on my protein shakes. To my utter surprise, they had a new flavor on the shelf...

BANANA! I tell you it doesn't get much better than this. The possibilities are endless. Use orange juice instead of milk and Bam! Breakfast shake! Add a touch of chocolate syrup and Bam! Frozen banana shake! Mix in a scoop of peanut butter and Bam! Elvis shake!

Pre- and Post-surgery weight gain just got a lot more tasty!

Two Years Later...

As I said, they took new pictures and x-rays when I went in a couple weeks ago. Well, as I'm sure you can tell, I was NOT prepared to have my picture taken but I thought I'd give you all the comparison anyway. This might be a rare case where the Before actually looks better than the After! Ignoring the disheveled hair and beard-in-process it might not be too bad. And it seems like my teeth are more yellow now than before but I'm hoping it might just be the photo. (At any rate, those are going to get whitened one way or the other when it's all said and done.) So here is the Before and After:

Sweeeeeeeeeet.

Guess what I had taken today? If you guessed "surgical molds" you are correct! That's it! Bam! I'm ready for The Chainsaw! They also retook pictures and x-rays so I'll get those posted as soon as I can. So, as soon as we were done I called my primary care provider to get a referral to see my surgeon a second time. They said my ENT had to be the referring physician so they were kind enough to call him for me. (You may recall, the last time I went through these referral hoops, it took me almost half a year.) So hopefully I'll hear back from Veronica or Kim at The Chainsaw's office with an appointment for my second consultation. Anyway I'm totally stoked that I'm ready to go because it looks like my timeline for a May cut-up date should be attainable.

Whoooohoooo!

Makes Me Sad a Little

So I was at Dr.Misleh's today getting the grill detailed and after I was done, Dr. Misleh, myself, and Miko, my technician, were chatting about my surgery and Miko pointed out something a little astonishing to me. My incisors have little ridges on them called mamelons. They are completely normal and come with adult teeth when you get them. The odd thing is for someone my age to have them. Why? Because my teeth have never ground against each other in the front. And so, after surgery, they will soon finally disappear.

Goodbye, Little Mamelons. Goodbye.

What Can I Say

Things are slow. Patience is key. Since October every ortho appointment feels the same. I go in, sit down, get a new wire, get up, six weeks. I do have some news though.
After some pondering over a calendar here's what I figure: even if I'm "ready for surgery" by my February appointment, It'll be another month or so to get my surgical hooks on, then another month to get an appointment with The Chainsaw, then another month to get a hospital date. I don't think I'll be in until May or so.

In the meantime, I accepted an invite to a hockey tourney in Colorado at the end of April.

To fold that back into the purpose of this blog, I'm starting my weight gaining regiment again.

Sorry if it sounds like I'm losing steam here, I just don't like posting unless I have something to say you know?