Thursday, December 17, 2009

Five months later

Here we are nearly at the end of the year. School finished for my son today and it's time to move into holiday mode, yay! It feels to me as though my surgery and the fallout dominated my year.

Things are looking good though. I still take the nortriptyline every night (25mg) for the pain in my left jaw joint. At first I took 10mg and not much happened. Then when I was told to increase the dose I went to 15mg. No pain... then a few days later it returned. So up to 20mg - no pain - then a few days later it returned. Then up to 25mg and the same thing happened. It was as if my body was adjusting to the increased dose.

Then I saw my physio last week. He did some accupuncture in my jaw muscles. Yes it hurt a bit! As a result, the pain at night disappeared again - WITHOUT any further increase in dose - and hasn't returned. It didn't seem to improve my range of motion though (which I must say is pretty good anyway!).

Now I can get 3 fingertips in my mouth at a squeeze (which is normal for some people but less than what I used to have). I can really easily get my incisors together, and once I am warmed up I can easily get my lower jaw out beyond my upper. I can move my lower jaw over to the right but not as far as to the left. (I had zero movement there before the drug).

The physio said I can put the dose up much further if I want. It's only at about 50mg that it has any real brain effects. I notice absolutely no side effects at this dose. 25mg is actually considered to be the minimum effective dose. I think I'd probably give it up if it was affecting me in any other way.

Braces: damn those ugly things. I saw my orthodontist last week. He said not to worry about there not being enough contact between my molars on the right hand side. Once my braces are off the teeth will move together of their own accord. Also he said he can put some rubber bands on to make it happen and it will only take about a week. And he said that since we're trying to move the upper teeth around to the left it's a good thing that there's no bite there to impede that.

This spring hasn't opened up gaps showing that my teeth are moving around, but my midlines are closer. However the top midline is still well off to the left (how could they make such a mistake?). I made it clear I would really like it to be in the middle of my face. He still doesn't know if it will work or not. It depends how much gap this spring can open up between my top back right molars and then he can drag the neighbouring teeth around but doing that is really going to extend my treatment time.

However, I feel there is no option but to just put up with it and wait. Six months more.... a big drag but worth it in the long run. I have spent SO much money and been through so much that it's worth getting it totally right.

Every day I think how neat it is that my lips come together at rest.

I notice a habit of rubbing my incisors together. It's like my brain is really still a bit wierded out by them touching. I try to stop myself doing it because I'm scared it might lead to a night time habit. My brain sure isn't missing that feeling at the back with only the back left molars touching at rest though. Talk about ANNOYING. Getting rid of that is the absolute best thing about the surgery.

I talk about my brain as if it's separate to me there. It's as if there is a kind of primitive bit of my brain monitoring my bite that is a bit separate from my conscious brain. Am I alone in this? That's the bit of the brain that the night clenching used to come from (and according to my husband still does but just one click at a time, occasionally, not repetitively like before the surgery). It was trying to grind out the annoying bit. There was no other way to get rid of it (apart from surgery! My primitive bit didn't know about that!).

Also, when I think about different things or move different parts of my body I can feel which part of my brain is being used. Hmmmmm. Can anybody else do that?


  1. Hi! I'm the student you spoke with on the yahoo board. Is your ortho using TADs (temporary anchorage devices) to anchor the spring to pull your midline over?

    From what I understand, using your teeth to open up the space is a form of "slip anchorage" and not as effective as TADs which allow fixed skeletal anchoring of the spring.

    Mikey J

  2. Hi - I'm not sure what it's called but it's certainly attached to my teeth not my bones. It runs from my top back molar to my first premolar on the bottom jaw and has a way (hard to explain) of exerting forward force on the bottom teeth and backward force on the top ones. Will try to get a photo soon.
    I can now see some gaps opening where they should so I think it is working, but whether the gaps get big enough to actually get the midline to centre is yet to be revealed. The ortho said the opening of the upper gap (at the back molars) is the crucial thing he needs to be able to complete the trick. At present floss removes rather a lot of food from in there, which is my best gap indicator!
    Although I'm now 37 my teeth have so far been fairly quick to move where the braces tell them to.

  3. Hi Andrea! It's really good to see an update from you. Hoepfully your joints will cooperate soon sans-medication.

    Stay in touch!