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@sarpe2011-blog
November 5th
October 1st
Left side
Right side space
September 6th
The Gap Closing ~ Week 2
I stopped expanding exactly two weeks ago, on August 4th. My orthodontist placed a new clear elastic chain across my upper teeth’s brackets, and this should start to really pull my teeth back together and close up the gap. I dont really notice the gap diminishing at all though, but I think it will take a couple of months. He wanted to schedule me to see him after 8 weeks, but I will see him a bit sooner, in 7 weeks from our last visit.
During this last meeting he also adjusted and tightened my lower braces, something that hasn't been done since they were put on about four months ago. My appointment with him was at 10am in the morning and by 5pm in the afternoon I was in a mental-physical pain thunderstorm. I never experienced the "brace pain" that I was warned about so often the other visits when my upper braces had been adjusted. I figured I was was just lucky and just didn't react like most people expected me to, but not this time. The pain was so excruciating I was totally impaired at work, for hours and hours I was in anguish and shock. As soon as I got home I took 800 mg of Ibuprophine and two vicodin pills, and went to bed.
You can notice my wonderful tilt in this second photo. The second surgery will be focused on correcting that. You can really see how the right side of my face is longer, hence the jaw slant and the huge space. Yes, this is me biting down and I can't chew for obvious reasons.
Lateral Xray~ notice the extra inch of length on the left jaw... You can see the difference because of the grey-shading. :-/ literally. I know most people aren't perfectly symmetrical but it still feel like a new huge reason to feel different.
The Expansion ~ Day 14
My jaw morphosis has become a central and pivotal part of my existence. I have become quite used to the gap now, and have had several positive comments about it. Shopping twice, I had random fashionable men tell me they liked the braces and thought it was cute, I felt like they perceived it as an accessory of some sort, even at a party a few nights ago I had an adamant female gap supporter walk right up to me and beg that I never close the gap because it is a lucky trait! She had one too, but it was just a sliver compared to mine... I've been highly amused and encouraged by these comments, and am actually quite relaxed now about my dental situation, which seems to be the focus of my face. I've also done plently of gap-toothed model google searching for moral support, and can spot a gap a mile away now in a magazine or even casually looking at peoples mouths as they talk. I am just keeping my fingers crossed the gap doesn't become so big to make me look like a girl from a hillbilly horror movie.
I am deeply relieved and gratefull that my orthodontist has put a white plastic/elastic chain over my upper braces which will diminish and I think even pull back together the parting of my two front teeth. The white elastic is friendly looking, and it actually seems to cover up the gap a bit. Already its effects are evident: instead of having a 6mm gap on the 12th day of twisting, I still just had a 5mm gap. The gap is probably a little bigger today, which is day 14.
Good news is no one seems worried that my tooth is exposed more on the left, and no one seems to think my jaw isn't expanding evenly. That's a gigantic relief. I saw my surgeon and the resident on Tuesday. Unfortunately it's clear and obvious to us all that my lower jaw is off center, and tilted, therefor even after correcting my upper palate my bite will not properly close. She said the second lower jaw surgery will be necessary. Never did I think it would be so important to finish what I started. I prepared for the worst mentally already, I thought the second surgery would be six weeks of a wired jaw, but before leaving my appointment I asked the resident and he said that six weeks was oldschool, and now it would probably be for only for ten days! The vision of just ten days of a wired jaw and drinking through a straw seems like such a breeze now, comparitively, and not nearly as horrific and impairing as six weeks.
I see my orthodontist tomorrow. I'm excited to ask him how much more to go and if he can give me an estimate for my gap expansion.
Day 8 ~ 16 twists. The gap is very big. Im barely comfortable now baring my teeth.
Ok...Maybe it is expanding evenly, todays photo montage gives me a bit more hope...But I will keep monitoring, not sure if photos had exact angle on me... Upper photo: day 1, two twists. Bottom photo: day 6, 12 twists.
The Expansion ~ Day Six
I have a quesy gut feeling something is wrong, and I don't want to feel quesy anymore. I fear my expansion is uneven. I say this because to the naked eye it seems like my right tooth is properly sliding off to the right, whereas my left tooth seems to be stable and in the same spot. Everyone had warned me to pay attention if I noticed that my palate wasnt expanding evenly.
I went to have a check-up with my surgeon this morning. I met first with her assistant, a young man in residency whom I like very much, and told him my suspicions. I had juxtapozed a photo of my toothy-smile from day 1 of expansion with a photo of my toothy-smile from yesterday, day 5. It seemed to me that my left tooth was in the same position as day 1.
I re-explained this to my surgeon when she entered the office, she said that was very clever of me. She illuminated various post-sarpe xrays and pointed out to me how my lower jaw is tilted, and that this probably makes the gap look asymmetrical. Shocking: basically one side of my face is 1cm longer than the other. I feel like everything is wrong in my structure now, and she said they could take care of this also with surgery, but I can't really think about it. She also said that its unlikely that I'm not expanding evenly because she had felt my broken upper jaw while I was under anesthesia and that both sides seemed to have the same mobility. That was good to hear, but then I also heard her tell her assistant that the break line in the xray was not as visible on the left side as it was on the right side. That made my ears perk up even more, because my sister had also noticed that (she's a doctor btw).
My surgeon left the office, I felt a little more optimistic about my expansion since everone else did, and her assistants showed me how to twist the expander myself, which I learned finally today. Thank god for my sister, I can finally relieve her of the act. I went home soon after and looked at my smile in the mirror, my gap is wider, yes, but I still think my left tooth is in the same hang out spot. I think that the last two twists have also pulled more gum off of the left tooth, revealing more of it. I'm not sure this is a good thing. You can even see it in this photo, from a distance:
Its been exactly 8 days now since SARPE and Day Three of the expansion process.
The gap its still at its "cute stage", as my sister says, especially since my face is finally not so swollen. Today is also the day I officially feel more physically energized and more like myself again.
The Expansion ~ Day 1
Six days after my SARPE I have begun to twist my palatal expander's key! I visited my orthodontist this morning who showed my sister and I how to do this, as its easier for someone else to do it for you, although I am determined to learn it myself as not to burden her any further!
He instructed me to twist it twice a day, once in the morning & once at night, for the next 7 days until I meet with him again. Every two turns is about 1mm, and I'll probably go up to 8mm by the time I see him next. 8mm is almost a centimetre!!! That's a space as wide as a tooth almost, that's a BIG GAP.
I also have a check-up appointment with my surgeon next week so she can also monitor the progress and look at my post-SARPE digital x-rays which were taken yesterday. I'm hoping they broke my jaw in all the right places so it expands evenly.
The twisting does not hurt, but is a bit unsettling. All I felt was a mild pressure as it was being twisted wider inside my mouth. When I walked out of the office this morning I looked at my teeth in a mirror, and yes, the GAP has begun. I am still chipmunk-cheeked and now the tooth gap, too. It's ok.
I have to admit that despite everything I am excited, and nervous.
Post-Surgery
I began to perceive light on my eyelids, my body felt heavy and still asleep, it was as if my mind woke up before my body. I knew what was happening and I focused my strength to wake up from the anesthesia. I still couldn't open my mouth or move, as my eyes opened first. I could see I was in the PACU (recovery) room, there were other people around me laying down on their respective beds. Finally I came back to my body and started to writhe, and moan.
The surgery took an hour and twenty minutes instead of the estimated forty five minutes.
I was in an utter daze, I felt weak, I was shivering cold, and in a lot of pain; an all-pervading pain that throbbed in my head, temples, and mouth.
The nurse asked if I wanted pain killers, which she would give to me through the IV tube, I pleaded yes, and she dosed me three times, within an hour-ish with dilaudid, which is in the same family of morphine. She told me she maxed me out and that my sister was worried and waiting for me.
The drug definitely blanked out my pain receptors for a dozen minutes or so every time I was dosed, or at least it seemed to last that long. I could feel the drug kick in and it gave me an extremely bliss-sleepy-floating-body high. The rush and numbness was relieving, but the pain would steadily seep back in, which is when I would start groaning again and she would re-dose me.
The nurse thought it would take me half hour or so to recuperate from the anesthesia once I had finally opened my eyes, but instead it took much longer, and I was out of the recovery room after another hour and twenty minutes.
When the nurse said it was time for me to go, another nurse appeared and helped me dress into my clothes, and they wheel chaired me out of the hospital. I was still very dazed, half-asleep, and profusely bleeding from my nose and mouth. They gave me tissues, and wheeled me out in front of the hospital where my sister had pulled up in her car.
My head was hanging to the side, and I was so out of it I didn't care how scary I must have seemed to the oncoming pedestrians making their way into the hospital. I was rolled up to the car, they opened the door, and I plopped into the passenger seat and spent the ride home groaning, bleeding, and not able at all to talk or listen to my sister speak because it was too stimulating and painful. None of this was acute pain, but like I mentioned earlier it was an all-pervading, dense, thick, throbbing pain, like a major migraine.
It was difficult to walk out of the car, and up the stairs to the apartment, my sister helped support me, of course. Once inside our home I immediately laid down on the couch. I was to sit or lay down with my back erect, leaning against big pillows, to prevent blood pressure from building up in my head.
I was still very much out of it, consciousness wise, still half asleep, and I was bleeding briskly. My sister put towels over the pillow I was leaning on so they wouldn't get stained, and covered me with blankets as I was still cold, and immediately got ice-bags for the swelling which was starting. I also felt itchy which I was told is a side affect of the anesthesia.
I was also incredibly nauseous, I would say this sensation was more disturbing than the pain. My sister played Tibetan chanting and music to help soothe and relax me. The nausea was horrible though, probably from the anesthesia, morphine, and blood that I swallowed into my stomach.
By this point I had been fasting since the night before the operation so we thought perhaps food intake would help ground me back to reality and give me some strength. I tried to have a bite of soup probably 5 or 6 hours after arriving home, I had one bite but was so nauseous I could not continue to eat.
I wailed in utter discomfort, and not knowing it was a bad move I let my head drop forward, my chin towards my chest, and I think that this let the blood rush and flood into my head. Letting my head hang this way caused so much pain that I almost blacked out.
I was crying and peaking from discomfort and nausea and so my sister brought out a small wash tub for me to purge into. I did finally free myself and vomited what looked like half a liter of blood in the tub. I had probably swallowed blood that escaped the suction tubes during the operation and more from after the operation.
After purging almost all the nausea disappeared. This was a huge relief comfort-wise. I ate nothing until 10am the day after surgery. My first meal was half a bowl of warm beet and leek soup my sister blended for me. It was delicious and I felt a bit better.
My surgeon warned me that the peak swelling days would be the 3rd and 4th after surgery. The best way to treat this is with ice, and by staying with my head elevated.
I spent the first 5 days post-SARPE primarily on the bed or couch, laying down with a propped up head, and icing my cheeks religiously. It was hard to think clearly or get any "work" done during these days. I spent these first five days resting, listening to books on tape, watching movies, and staring into space. I also took Vicodin, a painkiller, but I probably only used 5mg once or twice a day to help dilute the migraine-like pain.
I also took homeopathic arnica which reduces swelling, symphytum officinale for bone healing, and staphysagria for surgical wound healing, 3x a day for 6 days.
During surgery they stretched out my facial nerves so much that I could not, and still cannot, feel most of my cheeks, nose, and all of my upper jaw/lip/gum etc. The doctors say numbness will remain for several months, maximum up to six. They broke my jaw in three places, so its actually good that I cant feel the pain.
this is a photo 5 days after the operation, I am still poofy but this is also when I was just starting to feel more energy and clarity.
The Operation
After numerous professional opinions I finally decided to commit and go through with the operation with is called SURGICALLY ASSISTED RAPID PALATAL EXPANSION, aka "SARPE". I found a great surgeon and a great orthodontic clinic. I first got braces to straighten out my teethe, as was prescribed. I had a few very snaggly canines and crowding on my top row of teethe. After not even three months of wearing braces my teethe became significantly straight.
For the day of surgery I was still wearing the braces. I had to fast for 12 hours before my arriving to the hospital, this meant absolutely no food or water, which is pretty easy if you have a morning appointment. I hydrated a lot the day before my surgery, and ate a healthy dinner of swordfish, dandelion greens, and brown rice, with little salt, and drank lots of water the 14th hour before my appointment. I took a Zanex, an anti-anxiety medicine, the night before which had been prescribed to my request from my surgeon. I listened to my guided imagery cd the almost every night and morning for three weeks before my surgery, I did the same the night before.
I went to the hospital at 10:30am the next morning. I was changed into my hospital-robe, cap, and socks, and was given an IV tube in my right hand. I was very nervous, and cold feel my sweat drops rolling down my ribs under the papery gown. I have to admit I was very lucky because the nurses attending me were very sweet, and gave me Valium to chew (this way it is absorbed faster in one's system), and I swallowed it with a bit of water. This really helped relax me. I don't think I had a proper anesthesiologist, as I was only introduced to a nurse-anesthesiologist, she also aske me the routine questions of allergies, and stating what surgery I was about to undergo.
My sister who was is the waiting room this time was allowed to visit me five minutes before I was to be escorted off to the operating room, she gave me my i-pod which had a special track from my guided imagery cd. The song was specifically to be listened to during surgery. I was in a great mood because of the Valium. I'm really glad I took this because I was really tense despite all my efforts to stay relaxed. It simply gave me a light wine-buzz that made me smiley and happy. The nurses made cute jokes at me that made the whole experience lighter.
I was then brought to the operating room where the surgery was to take place. It was a crazy looking room with thousands of colorful-blinking buttons and lights, and massive surgical machinery. It looked like the inside of an alien space-ship to me, or maybe the cock-pick of an airplane. The buttons seemed to run on every surface, up the walls all the way up to the ceiling, it could have been the meds I was on.
There was a big team waiting for me, perhaps 8 people. All the docs were in their full regalia and had their mouth masks on. I was still feeling good, perhaps a bit intimidated, and just said "Wow, this is intense!", I couldn't see if they were smiling back at me of course. My surgeon then guided me to lay down and asked me to confirm with her what surgery I was about to undergo, this must be a legal formality, and then she told me I was allowed to turn on my i-pod where I had my guided meditation/visualization song set up. I heard the music start...maybe three seconds? And that's all. I was then fully under the effects of anesthesia running through me.
This is one of the few photos I found of myself with braces on. I actually felt more self-conscious and funny looking with braces on than with my normal pre-brace smile. I did get used to them within a couple weeks, they do however make me feel like a teenager.