The Nitty-Gritty

You might have read words like maxillary impaction in my previous post that went right over your head and left you wondering, "Wait, what on earth are they doing to your jaw?" So, let me sum it up and get down to the nitty-gritty for you by defining a few key terms and further explaining my orthognathic surgery.

..."Orthog...what?"

Glossary:

• Maxilla: upper jaw. The jaw that they'll be operating on.
• Maxillary: referring to the upper jaw
• Mandible: lower jaw. The jaw they won't be operating on.
• Mandibular: referring to the lower jaw

• Orthognathic: functional relationship of maxilla and mandible. Orthognathic surgery is what makes a disfunctional bite a funtional bite.
  
• Maxillofacial: of or relating to the jaws and face. Yep, it's just a fancy word for the jaw/face area.

• Malocclusion: a misalignment of teeth or incorrect relation between the teeth of the two dental arches. My malocclusion is called an 'open bite.'
  

  

  a classic open bite

• Open Bite: a malocclusion in which the front teeth, both upper and lower are forced outwards to an extent that the teeth of the upper and the lower jaw do not touch each other, even when the mouth is closed. Basically, my molars touch, but my front teeth do not.
• Impaction: the condition of being or process of becoming impacted. Okay, duh. But what this means in terms of orthognathic surgery is the fracturing/cutting of the jaw bone and pushing the two parts back together in a new way.
• Segmentation: division into separate parts or sections. My maxilla will be segmented into three different parts.
   

 My Surgery
What I'm having done is a maxillary impaction and segmentation. This means a few things in my case: (1) they'll be taking a few millimeters off of my top jaw, shortening it so that my lower jaw can come up and forward to better meet the upper teeth; (2) they'll be moving the top jaw forward a bit to account for this new upswing of the lower jaw; and (3) they'll be trisecting it—cutting the maxilla into three pieces so as to better maneuver correct occlusion.

Here is a photo of the projected changes the surgeon will make.

 (Sorry, it's hard to see. But the light grey lines are traced from my current face, 
and the dark grey lines are where the bones will be moved to during the surgery.)

To get a better idea, here are two quick videos that provide a visual of what I'll be having done:

 (unlike this video, I did not have any teeth removed, but rather small gaps created at the incisor teeth)

Playing Catch-Up: a timeline of the past year

I am not your typical jaw-surgery-having blogger. By that I mean that, unlike most of my orthognathic patient peers, I haven't been posting for the many months leading up to my surgery. As I mentioned before, it's been almost exactly one year since this journey to fixing my jaw really began, and obviously a lot has happened in those twelve months pertaining to this upcoming surgery of mine. So bare with my as I catch you up and give a general timeline of how I arrived here, one week pre-op.

2012

February: Got engaged to the love of my life. Realized that if I was going to get this surgery, it had to be in the next year, so as not to burden him with medical expenses and to look like my future-self in wedding photos.

March: Was put back on my family's insurance plan. Met with a family friend with an orthognathic background who confirmed I needed the surgery and referred me to maxillofacial surgeons in my area.

April: Had a consultation with one of the maxillofacial surgeons that Mr. Family Friend recommended, who began working on my treatment options/plans by taking molds. His office began working on the insurance side of things.

May: Found an orthodontist, Dr. Rudolph Meyer, who ordered x-rays & photos and began working with the surgeon; together they decided upper jaw would be the best option and drew out rough surgical plans. Braces put on at the end of the month.

June: Letter sent to insurance asking for coverage for the surgery.

July-August: Five weeks in China, trying to eat with chopsticks and braces led to losing 10 pounds. Then vacation back in the states with family, gaining all the weight back. No real progress with my orthognathic process.

September: Insurance company declined the request to cover my surgery. Surgeon's office writes and sends an appeal.

October: Second denial from the insurance company received. Resorted to getting a second opinion with another surgeon and, therefore, met with Dr. Gary Wyatt, who I felt much better about and who ordered updated xrays/photographs and began working on letter to insurance company.

November/December: Officially made the switch to Dr. Wyatt as my surgeon. Insurance letter sent, fingers crossed, holidays celebrated.

2013 

January: Insurance finally accepted! Surgery date set for March 5th. Projections of my potential future face made and surgical plan decided on: maxilliary trisection & impaction with chin advancement.

February: Lots of orthodontist, surgeon, and hospital appointments. Donated blood to myself (precautionary surgical measure), surgical splint molds taken, screened by Hoag for pre-op (EKG, chest x-ray, and blood panel), surgical brackets/hooks put on, etc.

And now, here we are—almost to March, and almost to the big day! I'll keep posting as I continue prepping for next week, giving you all as much info and/or advice as I can in just six days...

But, why?

Hi everybody—friends, family, total strangers, whoever you are!

After about a year of preparation, consultations with surgeons, insurance struggles, having my teeth yanked into place, etc. it's finally time. I'll be rolling into the hospital in just a week for orthognathic surgery. But you might be wondering...WHY?

Why Am I Getting Surgery?
     I had my first visit with an orthodontist in the 8th grade (2003), at which point he looked at my mouth, my bite, my teeth, and with a hint perplexity in his voice said, "We'll do what we can for you, but it looks like you'll need surgery some day." As a narrow minded adolescent, I was consumed with self-conscious fears of this man putting ugly metal brackets on my teeth, leaving me hopelessly incapable of getting a boyfriend—oh, the horror—and the whole idea of surgery went in one ear and out the other. I got the braces (and a boyfriend, I'll have you know, whom I'll be marrying in just five months...but more on that later). They straightened my teeth but did not fix my open bite.
     Fast forward about seven years. With only my molars touching, I'd never been able to bite my food. I thought the worst thing about this was merely having to tear or cut most of my food before putting it in my mouth, and therefore being teased by friends who referred to me as a chipmunk every once in a while. But one day I opened wide to bite into an apple, and shooting pain exploded in my jaw. Dang it. TMJ—a common symptom of incorrect jaw alignment—had begun to set in, and it quickly became uncomfortable to eat things other than apples. I did some research and my orthodontist's words from long ago echoed in my mind: I was going to need surgery.
     So, after nearly a year of trying to get me back on my parents' insurance plan, I began meeting with surgeons, each of whom told me I would indeed need jaw surgery—some said upper jaw, some said lower jaw, some said both. The braces got put back on at the end of May 2012, and in November I settled on a surgeon. We decided on a surgery plan: the upper jaw will be shortened, cut into three pieces, and brought forward to better align my bite, and the chin will be advanced as well to tighten neck muscles, which helps further prevent TMJ, sleep apnea, etcetera. My surgery date has been set for March 5th—like I said, one week from today.

Why Am I Blogging?
I hadn't planned on making a blog; in fact, I had told myself I absolutely would do no such thing. It's too much work. No one needs to see my frighteningly swollen face. I won't feel well enough to update it. There's plenty of reasons not to do it. But, just recently I realized there's just as many reasons to do it as well. Reading other people's thoughts, seeing their photos, watching their videos while they go through this process has been extremely helpful to me. I've taken the advice other jaw-surgery-having bloggers have offered, I've felt comforted by the fact others are experiencing similar struggles and successes, and I've been able to get an inside look at what's ahead for me—the good and the bad. I've come to the conclusion that it would be a bit selfish for me not to do the same for others in my boat, trying to find paddles and maps to help them get to where they need to go. Also, at my last appointment, the surgeon recommended keeping some form of a journal, as it can be cathartic for patients recovering from a surgery such as this. If writing my thoughts and posting some pictures will help others and myself, it would be nonsensical to remain stubbornly attached to the idea of not doing. So here it is: my jaw blog.

Those are the why's that have led me to this first post. And here's to many more posts to come!