Bummer

Had a joint-clinic session yesterday at the Queen Elizabeth Hosp.

Sigghhhh...

They put your hopes up by giving you a date for the op

then dash them by saying be ready for possible postponement...

it's such torture.

Found out some more that I'd be warded for close to two weeks at SMC.

Hmm... two weeks?

What am I going to do for two weeks?

How would I successfully occupy myself for the two weeks?

I'll be going for another dental appointment at the Luyang Clinic next Tuesday

to have my latest dental impressions done.

Looking back

Having time in mine hands, and having an internet connection led me to so many other blogs concerning jaw surgery and I particularly found Jannie's blogs interesting as I feel that what I am going through is almost similar.. If there is not going to be any changes to the date of surgery, I'll be having mine in about 19 days.

I should have made this blog a long time ago but pride kept me back. Sure, we ourselves are the worst critics and I am no better. Having the set of teeth that I have was one of many reasons why I had low esteem all these years. I made sure I was healthy, made sure I was fit, but if you THINK you haven't got a good smile, then babe.. you're not there.

That's why I am so glad my journey of being encased in these metal brackets is nearing completion. I am curious as to how I would look having a normal jaw, a 'normal' bite, a normal smile ..no.. a brilliant smile, and many more.

It's also ironic that the nearer I'm getting my jaw surgery done, the less worry I have of being photographed in 'awkward' poses. For example being taken from the side or having my profile taken.. My lower lip juts so far out you could rest a tray of drinks on them! I've come so far.. I've even planned to do something to my hair once I recover from the surgery.

I also should have posted 'before' pics of my teeth earlier.. not only for the benefit of others who suffer from this kind of malocclusion and crowding of teeth but also for myself.

First day wearing braces.. 13thOct2005

I was all smiles..excited but in pain actually. I kept wanting to trace the brackets and the back of my teeth with my tongue (which the doctor didn't encourage).

Sometime in Dec 2005 (2 months after)

I figured since I was going to be in braces a long time, I might as well enjoy the multi-colored o'rings available. This time I chose blue.


Oh..nothing to do with the braces.. just this phase I went through of removing the 130 moles (!!) I had on my face. Oh heck, said I, pain in the mouth, what're pain on the face, eh?

Will post some more later on.

Orthognathically Me

What is Orthognathic Surgery?

Orthognathic surgery is sometimes called "Surgical Orthodontics" because, just as an orthodontist repositions teeth, an oral and maxillofacial surgeon uses orthognathic surgery to reposition one or both jaws. Just as "orthodontics" means "straight teeth", "orthognathic" means "straight jaws". In fact, because moving the jaws also moves the teeth, orthognathic surgery is usually performed in conjunction with orthodontics so that the teeth are in proper position after surgery. The objective of orthognathic surgery is the correction of a wide range of minor and major facial and jaw irregularities, and benefits include an improved ability to chew, speak and breathe. In many cases an enhanced appearance can also result.
Who needs orthognathic surgery?

People who can potentially benefit from orthognathic surgery include those with an improper bite and those with jaws that are positioned incorrectly. Jaw growth is a slow and gradual process, and in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problem that can affect chewing function, speech, long-term oral health, and appearance. Injury to the jaw and birth defects can also affect jaw alignment. While orthodontics alone can correct many "bite" problems if only the teeth are involved, orthognathic surgery may be required if the jaws also need repositioning.
The following are some of the conditions that may indicate a need for orthognathic surgery:

difficulty chewing or biting into food
difficulty swallowing
speech problems
chronic jaw pain
excessive wearing of teeth
open bite (space between upper and lower front or back teeth when mouth is closed)
unbalanced facial appearance
facial injury or birth defects
receding chin
protruding jaw
inability to make lips meet without effort
chronic mouth breathing with dry mouth
sleep apnea (breathing problems when sleeping such as snoring)

Unequal growth of the jaws, injury or birth defects can produce problems and symptoms that require treatment by a team that usually includes an oral and maxillofacial surgeon, and orthodontist, and sometimes your dentist. In order to determine if you are a candidate for orthognathic surgery, and evaluation of your condition by this team in necessary.
Phases of Orthognathic Surgery
Pre-Surgical OrthodonticsIn many cases pre-surgical orthodontic is necessary to move your teeth into a new position prior to your surgery. During you surgery, adjustments will be made to your jaw to reposition them so that they fit together properly. Because your teeth are moved into a position that will be correct after surgery, you may think that your bite is getting worse rather than better during this phase of treatment. If you still have your wisdom teeth or other crowding, it may be necessary to remove certain teeth prior to beginning orthodontic treatment in order to make space for proper tooth movement.

Pre-Surgical Records

As your pre-surgical orthodontic treatment nears completion, an appointment with your doctor will be necessary to make final preparations for the surgical procedure. Additional records will be taken. Your dentist will look at your models and the most recent x-rays of your teeth and jaws to "simulate" surgery in order to finalize the surgical movements of your jaws. In other words, he will be doing a several mock surgeries on paper as well as models to insure that his predictions will give you the optimum final results.

Preparing For Surgery

You will be seen one more time in his office prior to your surgery. At this appointment he will do a history and physical as is required by the hospital before admission. The doctor will review your most recent health information and collect basic data about your current physical health. Orders for any tests that may be necessary prior to surgery are written up and a surgical consent form is signed. You will receive a packet of information that you will take with you to the hospital upon admission. In most cases, you will check into the hospital on the day of your surgery. Your anesthesiologist will discuss the general anesthetic procedure to be used. In addition to the general anesthesia that is given to "put you to sleep" you will be receiving intravenous fluids and medication to prevent dehydration and infection, and to minimize pain and swelling. It is very important that you adhere to any medication schedule or diet prescribed by your surgeon.

The Surgical Procedure

The orthognathic surgery itself will several hours depending on the amount and type of surgery needed. Certain movement may require the jaws to be separated into several parts, with bone added or removed to achieve the proper alignment and stability. Other facial bones that contribute to the imbalance may also be repositions, augmented, or reduced in size. For the majority of orthognathic cases, incisions are made inside the mouth and there will be no visible external scars. If there is a need to make any external incisions, care is taken to conceal the incisions in the natural skin creases.
The most common types of procedures used are:

Mandibular Osteotomy -(Also called a Mandibular Split) -

Allows for moving the lower jaw back or forwards to create a more stable bite and improve esthetics. This procedure can also be used to rotate the jaw if necessary.
Maxillary Le Fort Osteotomy -

Allows for repositioning of the upper jaw (maxilla). The jaw can be cut into pieces, if necessary, to reposition bony segments in their most ideal positions.

Another frequent procedure is a Genioplasty. A genioplasty can be used for repositioning the chin for a better esthetic result. It can be performed as a separate procedure, or can be performed at the time of your orthognathic surgery

Immediately Following Surgery

Immediately after surgery you will be moved to the recovery room until the general anesthesia has worn off. Your family may not be allowed in the recovery room, but they should be able to visit you shortly thereafter. An IV will be attached to your arm to provide required medications and nutrients until you are able to take sufficient liquids by mouth. Medications may be administered to control post-surgical discomfort.
The length of stay in the hospital can be one or more days. You can expect temporary swelling, especially of the lips and cheeks. Bruising may also result. These conditions are a part of your bodies normal healing response and should disappear during your initial recovery time.
To aid in healing, your jaws may need to be prevented from moving. This is done with the use of fixation appliances. In many cases the jaw sections are held together during the healing period by small screws placed by your doctor. In other cases wires are used to hold the bones together and keep the jaws from moving.
While your jaws are in fixation and healing, you will need to consume a liquid diet. Some weight loss may occur during this time but can be regained after the fixation period is over. During the first week after surgery your diet is extremely important. If necessary, you may need to supplement your diet with liquid vitamins or diet supplement drinks (example would be Ensure). A blender can be used to liquefy almost any food to provide a balanced diet.
Smoking is highly discouraged post-operatively for any surgical procedure, but especially following orthognathic surgery. Smoking can unnecessarily inhibit the healing process. Strenuous activities should be avoided during the first few post operative weeks.

During Healing

When you leave the hospital you should be able to return to work or school as soon as you feel like it. Most patients are back to their normal routine within 2 weeks. Your appearance may have changed somewhat due to the repositioning of your jaws and associated swelling. Friends and family may show signs of surprise, but it won't take long for them to adjust to the new you.
You will see your oral surgeon and your Orthodontist for regular evaluation visits. It is extremely important that these appointments are made in a timely manner and kept. The doctor will monitor your healing which will allow him to determine the appropriate time to remove any fixation devices that may have been used.
The initial healing process will take approximately 6 weeks. The compete healing process may take anywhere from 9 to 12 months. It is important to maintain a high level of oral hygiene during the entire healing process.
The Orthodontist will usually begin the post-surgical phase of orthodontic treatment 4 to 8 weeks after surgery to make any minor adjustments to your bite that may be necessary. IN most cases braces are removed within 6 to 12 months following surgery.

Drumroll

Golly..
So!!!
Dr. Normah says I am tentatively scheduled for surgery on the 15th of May.
I will have a joint clinic on the 29th. And on the 29th I am to bring with me 2 sets of x-rays of the parts of the dentistry that will be going through alteration, and also RM500 for the metal plates and screws.
Dr. Normah explained a bit on how the procedure's going to be like. This and that and this and some more of that... I told her later that I had been watching lots of youtubes and read sites about jaw surgery and I pretty much know what's going to happen. I am just so there..

I later had another mould of my teeth taken by Dr. Mohd Azmi... Mcm mau tecabut my teeth too.
anyway.. here's hoping that the surgery will happen as planned.

skippety skip

''Hello, boleh bercakap dengan Cik natalie?"

"Iya.. bercakap."

"Selamat pagi. Ini Mazlan dari Pakar pergigian Hospital Queen Elizabeth ya."

"Oh.. Hospital Queen? Ada apa itu aa?" ( my heart made a leap! this could be it!)

" Iya. Kami mau buat appointment untuk cik."

"Oo. (Yahoooooo..).. Bila mau buat appointment tu?"

" Esok 23 hb April. pukul 8.30 pagi. Di Bangunan baru, di aras 2."

"Besok? "

Skippety skip!!! Hoppity Hop!!
The call came just minutes after I had posted the blog earlier. Guess the stars are shining down on me. Rolling... the ball is rolling...

what next?

Ooo kay...
A stroke of good luck! I said to myself as I hurriedly closed down the lid of my laptop. I had not been waiting 15 minutes when my number was called. I had just turned on my internet connection and was preparing to blog, you see. Normally, I'd be waiting for 30-45 minutes or more before my turn came up.

Uh huu... what happened? I sat on the dentist' chair and waited... for an obviously new ortho dentist. Later on I found out that she transferred from Ranau to replace Dr.Alvera who is now in UK to continue her post-graduate studies. When she comes back in 4 years time, she'll be a specialist. Oh joy.. can't wait. (hehe)

So, I was the guinea piggy for the new ortho dentist.. She was hesitant, unsure of how to connect the powerchain from one hook to another. Golly, she even asked the nurse to help her retract my cheek so that my teeth and gums would be better exposed. I tell you... never have I felt so... so.. my cheeks deliberately pinched.. the doc telling the male nurse to hold on to the mosquito.. don't let go aa.. ok.. hold this.. this way... don't move.. Huh.. it was almost comical..
She was literally wiping her brow after the ordeal.

Anyway.. I was hoping to ask Dr. Fatimah some questions and when she came over to ask me how I was doing. I said, ok.. but impatient.

So.. Dr. Normah the oral surgeon has put my name on the list for the surgery which hooooopefully (cross my fingers and my toes) will be soon. There are about 4 cancer patients on the list before me. Of course they must come before me as their cases are much more dire and crucial compared to mine. The thing now is.. my surgery will probably take more than 5 hours and OT time allocated is only around 4-5 hours (so the doc said). The departments are taking turns using the OT it seems. Sigh..

1 hour later or so.. i was out, with new o-rings. Dark green. My next appointment will be on the 9th of June 2009.

Before appointment

Do i look tired? Am still wearing baju kurung ni.. just after work.

Ate some chocolate cakes just before getting off the car. Hungry. Brushed my teeth with the toothbrush I always carry in my bag.

Appointment again..

Let's see...

It's now april.. and this is going to be only the 3rd time this year i'm visiting the dentist. Government... dare i complain? I should be getting these braces off by this time had i done that surgery last year november!
It has been a long wait..it has.
And this afternoon... i will be going to the Klinik Kesihatan Luyang for the 3rd checkup of the year!.. only the 3rd.. and i wonder what news mine ears will be hearing..
dare i (again) hope?
* oo.. we still haven't got news from the OT department... i think you still have to wait la aa...
*oo... the hospital hasn't given positive respond to our many requests... you are lucky.. some other critical patients still are yet to be operated... be patient la a..
* oo... no news yet la...
* oo.. next week, are you free for the operation?
Hahahaahahaha.. if the answer would be like the last option above, I would be the jolliest of the jolly-wannabe depression-induced-by-nonexistant-treatment lady.