Tow Mater's back!!!

About 2 weeks ago, I went to Philly and Dr. E installed my MSE (maxillary skeletal expander). I met with her at 9:30 that morning to have molds of my teeth taken and then I went back at 1pm to have the expander installed. I sat down in the chair that afternoon to find her beaming and so elated when she saw the expander, “oh, it’s perfect, I’m so excited”. Welp, that makes one of us, talk to me in 10 months when this sucker comes out. Then I’ll share in that excitement.

Dr. E placed the expander in my mouth, a damn perfect fit. Shit. She momentarily took it out, grabbed a piece of gauze and stuck it to the roof of my mouth. She gave me the spit suction thingy and said “don’t swallow”.

What? Why not? What would happen if I did?

Of course, my mouth is wide open with gauze stuffed in it, so I can’t ask. I’m beginning to think dentists do that, tell you something you’ll object to or question when you can’t. Then I remembered reading about the MSE installation procedure, ah yes, this was the topical anesthesia. Ok. But, naturally, I still had to swallow even though there was no saliva.

I sat there for what must have been 6 days, or perhaps 3 minutes. I sat there sucking up my own saliva and fighting the urge to swallow. wondering if the topical anesthesia would numb my trachea and I could make it into Final Destination 12 or whatever sequel they’re on, but thankfully that wasn’t in the cards.

Mini screw 1.8mm x 11mm

Dr. E came back and used those words dentists and doctors love to use, “pinch” and “pressure”. I’ve yet to feel a just a “pinch” when stuck with a needle, but I felt 8 stabs in my palate, 4 in the front and 4 in the back. I flinched in my chair with each one. Dr. E then cemented the expander in place and grabbed the first temporary anchorage device (TAD), commonly known as mini screws and began screwing them, one by one, into my palate.

Side note: The answer to the question that your brain has yet to formulate as you possibly sit in horror, is yes.  Through my skin. Into my bone. Awake.

Ratchet wrench

To install the mini screws, a power drill can be used, at about 30 rpm, but Dr. E chose a hand powered drill, what looked like a small socket wrench. My body was tense in anticipation. I felt some pressure in my head and sinuses and plenty of weird squeaks which I was assured was just the wrench. Dr. E struggled to get the screws, 11mm each, all the way in, “you have a very thick bone”, which I assume is because it was just broken last year, and bones, similar to skin forming scar tissue, heal thicker than pre-break.

Expander installed and screws hanging down.

Out of the 4 screws, 3 of them are hanging down about ¼”. Doesn’t seem like a lot, but in your mouth that’s most of the available real estate. They make it difficult to eat, brush my teeth and scrape my tongue raw, so I wad up a good bit of wax 24/7. This protects my tongue, but when I speak it sounds like I have a marble or 2 in my mouth. Spelling is fun…all my E’s, B’s, P’s, V’s, etc. sound the same. And sometimes, a piece of the wax breaks off while I’m speaking. If I’m not careful, it can go flying out of my mouth…FUN!

Wax covering screws

Dr. E turns the key 3 times and I show her assistant that I know how to turn it, so 4 total. I then leave and my palate feels ok…for about 3 hours. Then the headache and pain in my molars and sinuses began. I quickly popped 2-500mg rapid release Tylenol. Knowing that the device was screwed and cemented into my head, a wave of near panic would rush over me for a few moments until I could take a few deep breaths and soften my muscles.

Side note: Your pelvic floor muscles, those muscles that help you not use the restroom until you are ready or help you stop mid-stream and they are pretty influential. If the pelvic floor muscles are softened, meaning zero tension in them, then it is physiologically impossible for any other muscle in your body to feel tension. And zero muscle tension means it is impossible for you to feel stress in your body. No stress in your body means your brain is not stressed. So, soften those pelvic floor muscles!!! Seriously, it’s a game changer.  

Gary and I had a Hootie and the Blowfish concert the night my expander was installed and I was told I’d be good to go. I bought these tickets back in April and had been wanting to go since the 90’s. I asked to drive, hoping driving would be a distraction to my pain. We hopped in my car until Gary informed me that my bumped had completely fallen off, finally. It’s been held on with zip ties for years that would break and need to be put back on multiple times. Good times, so we take Gary’s car. 

Bumpers done:( I have a hood, it's popped in this picture

We met up with our friends at a restaurant beforehand and I mushed some ravioli down the old hatch followed by dessert, 2 more 500mg of Tylenol. At the concert, my misery continued to mount and thus came 2 more Tylenol, that’s 6 in a 4-hour period. I ended up telling Gary we had to leave early. 

The next day I even called out of work, which is something I rarely do as I understand the disruption it causes for my clients and I only earn money if I see clients, but there was no way I could make it through the day. I was up for 2-hours before I took a 3-hour nap. Is that still considered a nap if you go back to bed for longer than you had originally been awake? Whatever, it was a nap. I lounged on the couch the rest of the day.

That weekend we went car shopping, Gary and I knew it was coming, but I was exhausted, had a headache and it was hot out there! I also started turn the key to expand my palate, 2 in the morning and 2 in the evening. I was used to this though because it the same thing I did last year, just a different looking key.

It was recommended by Dr. E that I purchase a waterpik to keep the area clean to ensure my puncture wounds healed quickly and there were no other infections from food. If you’ve never had one, don’t do it! They’re evil. Whoever said “your gums want to be massaged” clearly never asked my gums! At first attempt, I soaked the bathroom. The directions stress the proper 90-degree alignment of the water stream to your gums, but how the hell am I supposed to see that without a mirror?

While changing out the wax a few days later, I noticed a pick stuck between my palate and the expander. I tried to get it with everything I could think of, but I wasn’t confident I got it all. Poor Gary has had so many new roles as my husband that I’m confident he didn’t imagine on our wedding day. Some include: “can you turn my key, I lost the hole” (last year after my SARPE), “do I have food stuck back here”, and others. At least with this procedure, he only had to forego giving me a kiss for 2 days. Last year, after the SARPE I wouldn’t let him near my mouth for closer to 2 weeks.

Expander key & video of me
turning the expander

             

So, his new role, was to aim the waterpik above my expander and dislodge the wax or food that was stuck up there. I stood in the shower and shit was literally flying out of my mouth and down my chin and water sprayed back into his face and ugh! That man is more help through all of this than I could have imagined. We decided that I’d finagle with the waterpik and do it myself next time.

Being that I’m in Baltimore and Dr. E is outside of Philly, she has me text her pictures once my split appeared, that was Sunday. That damn gap was back. Sigh. Everyone says it’s “so cute”, but I’ll be totally honest, it’s hard having it at times. I know people judge me with it, at this point it’s more like 5mm wide. It makes me middle teeth look super large (they are veneers that are, in fact, larger than me and my dentist would like, and the gap doesn’t look natural. It’s also odd for me, as a therapist, to decide to tell my clients about my dental work or not. Imagine seeing someone on a weekly basis and then they suddenly have a 5mm gap between their teeth for the second time in 13 months. Some clients, I truly don’t think have noticed (I painted the walls of my office blue from pink and most never noticed or asked a year or more later if I’d just done it), some probably feel too uncomfortable to ask and a small few, 3 have mentioned it, thankfully in very compassionate ways.

Gap....AGAIN!

One of the things I forgot to mention with my SARPE, is that because I have a foreign object in my mouth, my body wants to fight it off. This means produce more saliva while my body gets used to the fact that it’s not going anywhere. The extra saliva means that I’ll wake myself up at night with drool down my face and onto my pillow. Good times! A few times, if my mouth is open, remember I’m a mouth breather, I’m drip some drool onto whatever is below me. And I’m pretty afraid I’ll drool one day onto Gary while kissing him. He’s really hoping that one doesn’t happen. Can’t blame him.

Two weeks after the expander was installed, I headed back to Philly to see Dr. E. I know I get excited with a new trauma client comes into my office because I’m like “yes, I can help this person”, but I don’t like being on the other side. Dr. E is so ear-to-ear grin with my gap and the progress I’ve made. Again, she’s in a boat all alone.

Knowing braces are in my extreme future, I decided to transfer my orthodontics treatment to Dr. E also. I need less cooks in my kitchen, so to say, so 3 doctors are better than 4 at the moment. And attempting to coordinate between doctors is honestly one of the most difficult aspects of all this. 

I got an updated fee schedule from Dr. E’s office, which includes the braces and expander.  

I already paid $1,000 when I scheduled the expander procedure and already made a $500 payment on that…$2,500 on the $4,000 expander bill. With the braces though, I now owe $9,650 total. Ek.

I have to make a down payment of $1,500 at my next appointment on September 4th, followed by monthly payments of $679. Wowzers. I’m grateful I have found an ortho who understands my case. I’m grateful Gary is supportive and didn’t question my decision to transfer orthos. While we don't have extra money like that sitting around, I’m grateful we can make figure out where this money is coming from and make it work. But it’s still a lot of money and a huge adjustment to our monthly budget.

Spacers to prep teeth for braces

Dr. E told me to turn the key 12 more times at my most recent appointment. I also had spacers put in on my lower jaw to prep for the braces I’ll get on the 4^th of Sept. My lower jaw was miserable now, which was a nice reprieve from my upper jaw hating me. I woke up that night at 4am, ripped one of the spacers out, which I still need to put back in. I couldn’t fall back to sleep after that, which made for a long day at work.