Impressions :)

I still had hope…though it was diminishing.  I just wanted some good news.  I wanted my surgeon to tell me something good.

I went to him with the information from the orthodontist.  I explained that even though I understood that the Orgonathic surgery is small and relatively easy, it sounded horrendous.  He put my mind at ease by explaining that he can do the Orgonathic surgery without additional pins and/plates being put in my jaw.  This made me ecstatic. 

He then gave me even better news: since I wear my retainers religiously, I might not need braces.  I needed to have bite impressions made to see exactly what needed to be done.

The bite impression cost approximately $160.  Once made they are sent away and models of my teeth are made and sent back to the office.

Neither medical nor dental insurance covered the cost of the impressions, but I was willing to spend the money to find out if I would need braces for a third time in my life.  I was definitely optimistic and praying for some good news. 

              The office took two sets of impressions, but I'm not sure what the 2nd set looked like.

Meanwhile, I was still struggling with whether or not I wanted Total Joint Replacement and Orgonathic surgery, or if I just wanted to wait.  The surgery is huge and frightening, and though I am normally quite decisive I couldn’t decide.  Not only that, but normally I trust my gut instinct, yet it almost felt as if all my instincts were gone. 

I discussed my options with my friends and family, yet knew that ultimately the decision was mine. 

The Second Opinion

Goodbyes are difficult

I spent two wonderful years in Kochi, Japan.  I had a fabulous job as an Assistant Language Teacher (ALT) at Nakamura Jr & Sr High School.  I made many friends and learned much about the culture, language, and traditions.

                                              Nakamura Jr & Sr High School

I came home and made an appointment with my OMS surgeon.  He could see the problem with my bite right away.  He wanted me to go an orthodontist, and get a second opinion with them.  I had my fingers crossed because I didn’t want surgery again.  Not only did I not want surgery, I was hoping for some miracle.

An open bite

The orthodontist staff took my history and some basic x-rays.  Then the oral surgeon came in to see me, and let me know that I am not a candidate for braces.  My jaw is much too unstable and until I have total joint replacement (TJR) and Orognathic surgery, which can be done at one time. 

Orognathic surgery-what it looks like

I left his office with a pamphlet about Orognathic surgery, and felt a bit defeated.  This type of surgery is used to fix gross jaw discrepancies or facial skeletal discrepancies.  The surgeon makes an incision inside your mouth and they often cut the jawbone in several pieces, manipulate it into place, and pin it together.

I made an appointment with my OMS surgeon to discuss my options. 

TMJ Arthroplasty/open joint surgery

TMJ arthroplasty, or open joint surgery, was the next step in my journey.  My discs where bilaterally dislocated, and it was causing nerve damage on the left side of my face.  In my case, a discectomy (the disc was removed) was necessary.

Open joint surgery is when an incision is made along the outside of your ears, much like a facelift.  The joint is then exposed so the surgeon can easily see what he/she is doing.

After the disc is removed, the surgeon will replace it.  There are several options.  Some doctors prefer to use muscle grafts, but mine used a temporary silicone implant.  This implant was held in place using internal stitches.  It was explained to me that my body will create some sort of tissue on top of the implant, and once the implant is removed the tissue will suffice as a cushion so there is no bone-to-bone rubbing.

I left the hospital 24 hours later.  I began doing physical therapy exercises.  I was given pain medication and a topical ointment for my stitches.  I iced my face to reduce swelling.  I was also on a liquid diet for approximately 4/5 weeks, and then a very soft diet.  In addition, I slept sitting up.

I was on pain medication for 24 hours before it made me violently ill.  After that, I sucked it up and went without anything.  I am relatively active and began taking walks two days later.  Those walks got longer and longer as time went on!

A week later I went and had my external stitches removed.  My healing was going really well.  Once my stitches were out, I even went clubbing with my friends!  I, of course, was very careful with my face.  I didn't allow people to hug me, or touch my face at all.

  My friend's bachelorette party two weeks after surgery

Nearly six weeks later, I went to the surgeon’s office and had my implants removed.  This is not done while a person is asleep.  The doctor numbed one side of my face (ouch!) and made an incision, pulled the implant out, and stitched me back together.  He repeated that on the other side!  It was very cool and I even got to hold my implant!  I wish I had taken pictures of it for this blog :/

The next day I went to my friend’s bridal shower, and unless you were standing on either side of me, you would not even know I had stitches.  My doctor is that good!

My other friend's bridal shower-I have stitched on both sides of my face from having the implants removed the day before.

I left and went back to japan.  I recognized that my teeth where not lining up correctly, and I began to be in pain.  I was in denial that something was wrong, until one night I went to eat ramen with my good friend Andrew.  Eating the soup was difficult, and I was in pain for days.  I knew something was very wrong; however, I didn’t know what. 

Ramen-tantanmen, or spicy ramen, is my absolute favorite type!!!!!  I miss ramen!

I have read that this type of surgery is successful for many people, and I am jealous!  I wish it had been successful for me. As of now, I am still optimistic that there will be a cure for my constant pain.  

And so the doctor's appointments begin :)

In 2011, I went to an Oral Maxillofacial surgeon and he suggested cleaning out my joints.  He didn’t order an MRI; he only did panoramic x-rays.  Eager to be healed, I went in for the simple surgery.  Healing was quick, yet nothing changed.  The next year, he said he was going to reposition my disc and I would probably have to spend the night in the hospital.  I went in for surgery, and woke up later that same day to find he had only cleaned my joints again.  I was disappointed because I didn’t want that done, and knew it wouldn’t work.  As a result of the surgery, the muscle on the left side of my face was tight and I eventually received Botox to fix it. 

Here’s what I have learned from that experience:

  1)  Double and triple check who your doctor is and what he/she is capable of doing.  Some doctors        specialize in certain things and can’t handle serious jaw issues.

   2)   Get a second opinion. 

   3)  If you think your doctor should be doing something and is not, ask him/her.

   4)  Just because a friend had the same procedure and it worked for them, doesn’t mean it will work         for you.  Everyone’s body is different and everyone heals differently.

   5)  Ask questions!  I now write down questions to bring to the OMS surgeon.  I ask anything and  everything that comes to mind, even if it appears to be a stupid question.

Eventually I heard about one of the top OMS surgeons in the country and went to him.  Besides the panoramic x-rays, he immediately sent me for an MRI.  The MRI showed that my disc was dislocated.  I was also tested for Rheumatoid Arthritis, and my hormone levels where checked.  After all the tests, I had disc-repositioning surgery.  This was painful and caused a lot of muscular problems on my left side.  Luckily, I have good friends who weren’t embarrassed to go out with me and would make me laugh.  I was extremely self-conscious about the muscular changes, even though I realized they were only temporary.  My one friend would casually walk by my and tell me to quit smiling because I looked slow.  This may sound mean, but it made me laugh and she said it in a very silly way. 

Approximately six months later and I felt the discs slip out of place.  When this happened, it caused my left eye to begin twitching.   I was living and teaching in Japan, so I went to the hospital in Kochi City.  The specialist immediately sent me for panoramic x-rays and an MRI.  I then went to his office for the results-the discs in my jaw bilaterally dislocated.  There was no specialist at that hospital that could deal with this problem, so I then made an appointment and drove to Kobe to see a specialist.  My doctor in Miami plays golf with this specialist when they are at conferences together, and he speaks very good English.  He reviewed everything and explained that since my jaw is a complicated case, he could not do anything to help.  He is only qualified to clean joints and basic oral surgery. 

Overall, his honesty was refreshing.  Though I was in pain and frustrated, I learned a great deal about socialized healthcare.  It was absolutely amazing to get all the tests I needed and have the doctor review the results in one day.  I believe I paid about $100 for the MRI, doctor’s visit, panoramic x-rays, muscle relaxers, Naproxen, anti-nausea medicine, and some sort of topical cream I never used.

                                  Me driving my Sazuki Alto across a bridge in Shimanto City

                                     

                                          In Kyoto I dressed like a geisha for some fun pics!

Overall, this is really the first time I have had to navigate healthcare, whether it was in America or in Japan.  This experience, through trial and error, has taught me a great deal about doctors, asking questions, and advocating for myself.