7-31-2019 Day after MSE Installation

Last night was really rough. Pain meds wore off and I slept terrible. I was up every hour to get ice and was just so tense and sore. I got up at 5 am to get ready for work and ate a yogurt and a banana just fine. I just really have to brush and rinse and use the water pick after food. Also I gave it the first crank just fine! Yay! So relieved because I didn't allow myself any spare time this morning to have to fight with it. I did take an Ibuprofen 800 at 5:30 am though, and that kept me good through work until about 2 pm.

Shake for a snack, and a smoothie for lunch kept me going until I got home about 4 pm. (I did stop and get some soft groceries on the way home as well- sweet potatoes, canned beans, apple sauce, yogurt, squash, more shakes, etc.)

Dinner was a quesadilla with refried beans and cheese, all soft. I admit, I ate it so fast I was pretty hungry, but washed up just fine afterwards. I plan on just bringing shakes to work so I don't have to go through the whole routine in a public bathroom. (I drive a lot and don't always know where I will have lunch until I am there so this is actually convenient and a cost savings for me). Dinner will be whatever at home.  Bonus, maybe I will drop a few lbs. I am trying to lose 20ish anyways.

But yes, I needed a Tylenol 3 after dinner. I got my ice pack and chilled out for an hour and now my tongue just feels really sore and a bit raw. I talked more than I planned on today and feel that's the likely cause. Also a bit of a sore throat feeling.

Anyways, my jaw has been the worst part. Just from being so fatigued and awkward. The screws were the easiest part! And the roof of my mouth is just fine, I even brushed it a bit earlier. I am mostly anticipated my TMJD to be really flared up from my bite being in a state of constant change for the next year >_<

My next appointment in August 8th, which is about day #10 for a check up, at the orthodontist.
I do also have the personal cell # of the periodontist in case I freak out, have a question, something starts hurting, etc. So far, I still really like and trust them.

And oh, by the way, I was 100% expecting the 8 mm MSE. Turns out the lab fit the 10 mm MSE II in there! https://www.moonmse.com/mse

Good night! 😬

July 30th, 2019 - MSE Installation Day!

The MSE is in! The whole process was actually no big deal! If I can do it, anyone can.
However once the numbing shots wore off, the day got a whole lot rougher...

9:30 am I started at the Orthodontist. They placed the MSE and cemented it in. This took about an hour, just to make sure everything was clean, dry, and I understood how to use the key to crank it open. My direction was 1 crank in the morning and 1 crank at bedtime.

11:00 am I was at the Periodontist. They were so wonderful, gave me play by play updates as they did every turn and poke. 2 big fat shots came first- these were not pleasant but over quickly and were ok enough to handle. Felt like a chopstick going up through my palet, and through bone that's for sure. A few more smaller (4? 6? couldn't tell) shots were next and I really didn't feel much at all when the screws were going in. The ones on the left felt a bit twingey (like a nerve pain?) and the back right one was so squeaky (my bone was the squeaky part she said). And although I didn't feel it then, I do feel something it in my sinuses. Like when you go outside in the dead of winter and breathe cold air in real hard/a brain freeze, but in your nose. A cold metal feeling. Not painful, but a little weird. This all took another hour, but that included me paying and getting another CBCT scan. I didn't feel rushed at all though. They were so calm and casual my anxiety was eased. I totally squeezed a little pillow the whole time though, just in case.

For me though, the worse part was having my mouth open for 2 hours. I've had wretched TMJD for 20 years so it's so fatigued it feels about to fall off. Couple that with no place for my tongue, which is now exhausted, and the obvious now my bites off feeling = ANTICIPATED HEADACHES FOR DAYS at the least. I've been on ice packs since I got home. Bonus, The perio did call in some Ibuprofen 800 and some Tylenol 3 for me. BLESS HER. But now I can't wear my bite splint. I've been dependent on it for-ev-ver so I'm just going to be a mess until I get stable again. Hopefully today was the worst, but, I know my past and why I am here.

I ''worked from home'' most of the day and answered emails etc etc, but tomorrow I have to go sit though a class 6 am-2:30 pm. I'll take it because I won't have to talk much, but I have to figure out how to crank this and be presentable by 5:30 am -_- Booo.

Also, dinner was rough. Food gets ALL up in this thing. The legs of it are pretty far off my mouth so entire peas and bites of chicken got all stuck. It was pretty gross but I invested in a water pick and power washed it all out. Tomorrow for work, I'm just packing like 4 shakes and will call it good. Perhaps I will lose this extra 20 lbs finally.

Anyways, more updates soon.

6-22-2019

I have an appointment to have the spacers put in AND lower braces put on!

July 17th is all starts. 7-10 days after that will be the big MSE day! 

https://damonbraces.com/treatment/adult/

https://youtu.be/fRPFx3rwoe8

My ortho is choosing to go with Damon Braces. The website is kind of cheesy but they seem fine. Clearly I need more help than Invisalign can offer. I am not sure, but I might need to wait the full 6 months of wearing the MSE before I can have the top ones on though.

More to come.

UPDATE July 17th:
We did not put on the lower braces. Turns out I may be just fine in Invisalign!! :D
Ortho wants to see how I open up and we can decide in a month or so which way to go.
Also the spacers were fine. Barely knew they were in. I just had to remember not to floss them out. 

6-12-2019 Scan

Hello world-

Today I went for a quick scan at the ortho, basically a 'camera on the end of a stick' was put in my mouth and moved around to capture a 3D image of my entire upper mouth and palate. This was needed so it could be sent with my CBCT to a lab/UCLA to make my custom fit MSE.

This was all fine, however, I am apparently so narrow and my palate is so high up that it took 2 techs trying to capture it all and a 3rd person pacing around looking confused! In the end they could NOT get the whole scan and had to call the lab to confirm that they had enough to model my MSE! I was feeling pretty special, that's for sure. This reminded me of the last time I had to have molds made with the goop-in-the-tray method for my last neuro-muscular bite splint: a tech tried approximately 26 trays before she found a child's mold that almost fit, but had to go heat it up so it would bend into more of a V shape to fit my lower jaw. -_-

Anyways, these scans took like 45 mins to get. I feel it should have taken 15? I hope everything comes back good enough as the ortho isn't even in the office until next Tuesday and the MSE is supposed to be ordered tomorrow.

Also, I am plagued with insomnia so I had a thought the other night and followed through. Yes, I can afford this treatment, however, I thought why not use a credit card and get cash back, bonus points, something... I found a credit card that gives me a $200 cash back bonus if I spend $1000+ the first month, plus 1% back on this type of purchase. And, if I pay up front in 'cash' at the doctors office I get 5% off their services....

THIS IS SAVING ME AN ADDITIONAL $745 and I have a 12 month 0% APR on the card, just as I would have a 12 month payment plan at the doctors! So, awesome! Much smart! Many responsible! This will also build my already great credit. Yesss.

Anyways, here's my mouth, sans the highest part of my palate-

6-6-2019 Helpful Info

https://www.moonmse.com/mse-article

https://docs.wixstatic.com/ugd/87f545_e7c83401dd5846faa06689ce5794fba0.pdf

https://www.dentistry.ucla.edu/learning/ucla-orthodontics

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398849/

and bless this woman for sharing:
https://youtu.be/OmdpelNHGys

Take some of these users with a few grains of salt, but great discusses are happening here:
https://the-great-work.org/

6-6-2019 - I made the decision, MSE here we go.

So, I made the call today. I am getting the MSE.

Next Wednesday, 6-12-2019 I have 1 more scan of my mouth, all my info gets sent off  to UCLA for my MSE to be custom fit to my mouth. It comes back 3 weeks later. By the time it arrives, I will have had spacers in for a week and will have the ortho glue it to the back teeth. Then I take the screws down the street to the Perio and she installs the tads. And hopefully a week or 2 after that I will post very sexy pics of my diastema! 

PS I am terrified. This will be the most invasion procedure I've even had. >_<

How was everyone elses experience with the installation? Please share!

4-30-2019 Email Update

I submitted, over 2 emails, additional questions that I forgot to ask to the orthodontist. Here are her replies!

First email:

1. Why the implanted expander and not a similar one that is not implanted? What is the benefit for my case? Any risks I should be aware of?
She was the first to recommend this to me; my other consultations recommended either no expander, a Schwartz expander or surgery. I was unaware of an implanted type and would just like more information as it seems a bit intense.

Docs response: The upper jaw is done growing at age 7, thus a conventional expander would do nothing more than tip the teeth in the current bone. The goal of an implant based expander is to actually expand the maxilla (upper jaw) and not just tip the teeth into a wider portion of the jaw. The benefit is your upper jaw is very narrow, try to regain ideal size, as well as improve the base of the nose thus helping you breath better through your nose. The risks are varied, I do not place the skeletal expander, my colleague the Periodontist does therefor the consult with her will answer more questions on the risks. The main risk I see presenting itself is the jaw may not separate and expand, the implants may not work. We do not know if this risk is going to present itself ahead of time, there are patients in the expander who have not expanded.

2. Would I get an expander on the lower jaw as well?

Docs response: We would not expand the lower jaw, in a true sense, as it is just one piece (the upper jaw is two pieces and can be pushed apart to be made wider). When an orthodontist is saying they would expand the lower jaw, we mean upright the teeth and make the teeth wider as that is the only option with the lower jaw.

3. What type of retainer can I expect to get once treatment is over? Permanent? Or perhaps one that looks like an Invisalign tray? And, can this be modified to also act as my night time TMD bite guard?

Docs response: Retention varies based on how each patient responds to treatment, in general for a case like yours I would anticipate a clear retainer (like Invisalign) that we modify to act as a bite guard as well, by adding acrylic.

4. Why types of scans do we do along the way?
I ask because working with my current NeuroMuscular “specialist” I was scanned, hooked up to a TENS unit for an hour, then re-scanned to find ‘where my jaw wanted to go’ before we made my current orthotic. Do you do similar scans, or would I see him on occasion to make sure my bite is progressing into the ‘correct’ location? Or neither

Docs response: The imaging would be a 3D CBCT to evaluate your anatomy for the MSE (maxillary skeletal expander) which would be taken pre and post op. We would also take radiographs in my office as needed to assess treatment and aid in treatment decisions. I do not use a TENS unit in office, I would be happy to try and work with your current provider to ensure the jaw position is ideal - which may require scans in their office. If we have a difference of opinion it would be up to you to determine how to proceed.

Second email, after I had the CBCT and consult with her Periodontist:

1. The periodontist mentioned that my lower jaw is pretty narrow and doesn't expand like the upper. She mentioned bone grafting, as a possibility way down the road, maybe-maybe not, if you needed help matching my lower teeth to my upper, once I'm fully expanded and in braces. That doesn't sound pleasant at all and I would like to avoid it. By looking at my scans, can you get me to 100% of my potential without that? 75%? I am willing to compromise if it's a high percent sans grafting. My goal is pain relief and breathing over aesthetics.

Docs response: This is a tough one because you are very narrow on the upper, and as an adult I have no way of knowing how your bone and soft tissue will respond. All I can say is we can 100% try to upright the lower teeth without any additional intervention.

2. Since my palate is expanding, does that expand the entire width of my upper jaw, TMJ to TMJ? Basically, will this process have a chance of making pain in these joints worse?

Docs response: There is always a chance, however I have yet to see that happen - there is a stronger correlation with the narrow jaw and TMJ symptoms. The expander would expand the entire upper jaw, but the TMJ joint is on the lower jaw

3. We didn't talk actual measurements from my CBCT. How bad is my airway, really? Everything I read online mentions specific measurements. Dr. Anderson mentioned I might need to see an ENT when I am all done with orthodontics to correct the deviated septum.

Docs response: There are no set guidelines for airway size and dimension, partially because the airway moves/flexes etc., can vary based on tongue posture in the image and head posture. I do not take airway measurements from the CBCT as I do not use the machine, but you could ask the Periodontist to have it read by a radiologist (there is a fee) for exact measurements. I recommend an airway case based off of symptoms and patients quality of life - I see it all the time where it "looks" like a horrible airway but they have no symptoms, and the reverse.

4. Once I start this process, my current bite guard/orthotic becomes obsolete. Would I go without one until I am brace-free, or just use a cheap DIY one from the store?

Docs response: Yes - we will try to make something if we can but because the teeth will be constantly moving something over the counter may need to be used.

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I understand any type of doctor can never give you a 100% chance of anything, but this all seems pretty good. Right? I should move forward with the MSE?? I do have to say, the ortho and perio were beyond attentive to my 4000 questions, did not make me feel rushed at all whatsoever and seem like legit really good people who want to help me feel better and not just look better. I'm scared but so far have no reason to believe this will hurt more than what I have been dealing with the last 20 years. And the MSE will be in for 6 months- It was $300 for the CBCT which is paid for already, $1000 for the perio and $500 for the Ortho. I can afford this now, or over the 6 months.