SARPE Surgery

[katsface]

Hi Vantwins and redwine, how are you guys doing? I really hope you're both feeling well, and redwine, I hope you're recovering well from your second round of expanding.

I got a few more details about my upcoming surgery. I'm supposed to go to a Dr. to have a complete pre-surgery work up to confirm that I'm healthy enough for surgery. Is that pretty standard? Anyone know what kinds of tests they do?

Also, I just found out that my surgery will be out-patient. It's being preformed in a hospital (and it's only a 5 minute drive from my apartment, so that's a plus!) but I'll be able to go home an hour or two after the surgery. I guess that's good, right? It will save me some hospital costs, anyway.

So far I hate this expander. It's killing my tongue, and it's installed so low in my mouth that I don't think I'll ever get over the speech impediment Impossible to say things like cute, you, or any long e sounds. And pretty much everything I say sounds like I'm talking with my mouth full (which I guess I kind of am).

I also just realized that while I've been reading everyone's stories on this board, I've been thinking I'll be doing an average amount of turns... around 26. But, boy was I wrong! That's how many DAYS I'll be turning! I'm actually doing something like 52 turns! Good golly!

Well, I hope everyone is recovering well! Talk to you soon!

[Vantwins]

Hi Kat - surgery coming soon, congrats! I did not have to see my regular doctor for tests before SARPE, but I will have to for my next double jaw surgery. Oh, you have so many turns, poor thing! I did 4 turns a day for a week. It was killing my tongue as well. Once I finished the turns, they put some sort of soft plaster over the middle of the appliance which was a huge help. Make sure to ask them about that. My SARPE was outpatient as well. My husband drove me home a couple hours after surgery. The nurse suggested I close my eyes the whole way home so I wouldn't get dizzy and nauseous and I think that was good advice!

Well, I've been on quite a whirlwind. I saw my new orthodontist. They didn't like the brackets my former ortho used or the placement, so they took them all off. They also said I could stand for the palate to narrow back a bit and they took the RPE out. I was SOOOOO happy to get rid of that. I mean, I feel like the SARPE was awful and was a waste of time, but I'm trying to just focus on the future. I go to a gum doctor next week to make sure none of my gum recession needs to be addressed immediately and if that's okay, I'll get new braces on end of next week. The new ortho says the things that are bothering me the most - one front tooth way lower than the other and the gap, they will fix immediately. Needless to say, I love the new ortho!!! I let the old ortho know I'm switching and am waiting to find out how much they plan on refunding. Hopefully it'll be fair and I won't need to fight with them. I got my teeth cleaned at the dentist today while I'm in between braces. Felt so weird - my top gums are still numb 2 months post surgery!

My next surgery will be in 9 -12 months.

Vanessa

[redwine]

Hi Katsface - glad to hear that things are moving along. I think the pre-surgery workup is pretty standard, expecially for us "older" patients. Mine did bloodwork, including a clotting test, as well as a EKG. No big deal. Good luck with your surgery!
I'm doing very well, I think. Bruising from 2nd "procedure" is gone and the swelling is going down nicely. I'm done turning - I had to expand to 10 mm and after the 2nd procedure, the gap opened an additional 2+ mm overnight. Since I've stopped turning, the gap is closing fairly quickly. I go on 2/12 to get wires changed on lowers, then uppers get braced on 3/14. At the rate I'm going, I may not have to deal with powerchains for long, if at all!
I've noticed several facial changes such as cheekbones, my eyes look more symmetrical, and (unfortunately) my overjet is far more pronounced. This has been interesting, to say the least.
Vantwins - 13mm?! Wow, by expander only went up to 11mm. That's a lot of expansion. Lucky for us it doesn't hurt. I've noticed that my mouth seems full of teeth which sounds odd, but it feels even odder. When I was expanding, I felt as though I needed to re-learn to talk every day. When do you get to stop turning?

[redwine]

Sorry guys - got the names mixed up.

[katsface]

Vanessa - Hows your new ortho working out for you? Have you gotten any word about a refund from your old ortho?

redwine - I'm glad to hear your gap is closing quickly on its own. Gives me hope. Although since I'm expanding so much I won't hold my breath that the gap will close on its own at all. I probably won't mind not being able to talk, since i can't talk with this expander in my mouth anyway.

Well, my surgery is still set for the 18th (eek!) and I've made my payment to the surgeon already. Also got my physical done and was cleared for surgery. I've been taking my supplements and bromelain. I'm getting really excited, but also really nervous.

Surgery will be outpatient, so I won't have to stay in the hospital very long. OS said the procedure will take about an hour, then I'll rest for an hour or two, then I'll be on my way.

I still don't know how long I have to wait after surgery to start turning the expander. I'm going to ask while I'm at the hospital. I also don't know if it's better to do both turns at the same time, or do one in the morning and one at night? I'll ask at the hospital, but if you guys have any advice I'll take it!

I guess I'm nervous about the surgery, but I'm almost equally nervous about the . I've been having a rough time socializing this month because I still sound ridiculous with the expander in. I know the gap might make me feel even more ridiculous, especially since I already know it's going to be BIG. I was chatting with the Dr. who did my physical, and she said something like "Laura Hutton has a gap, and she's hot." All I could do was laugh. Yeah, a "Madona/Lauren Hutton/Ruth Crilly gap" would be cute. I could try to rock that. But this isn't going to be a "Madona gap". It's going to be an "I lost one of more teeth in the front of my face gap".

But then again, it might make more sense to people why I'm talking funny if they can see the physical manifestation of the expander. At least then I can say 'I had jaw surgery, so I'm talking funny'. What I say now is "I have an expander in my mouth" which is greeted with blank stares. I mean, to people who have either seen the expander, or to whom I've described it as a horse bit in my mouth, well they understand a little better. I just don't want to go into that level of detail with store clerks

Anyway, I'm fully committed at this point. No turning back. I just want to get it over with!

[katsface]

Surgery yesterday went well. They had to give me a lot of morphine afterwards, and that made me feel ill, but they gave me some more anti nausea medicine which eventually made me feel better.

It was an outpatient surgery, and I think I might have rushed getting out of the phase 1 recover room a little soon. The nurse there was very nice, but I really had to use the restroom, and she wanted me to feel well enough to put my clothes on and go to the phase 2 recovery room before she would let me 'go'. I had to go so bad I told her I was ready to put my clothes on and go to phase 2, even though I probably should have rested a while longer. When I actually got up to go to the restroom, my nose bled, and I got so dizzy I almost passed out. So, for the kids at home, don't rush getting up!

My husband and I took a cab home, and the morphine made me walk like I was super drunk. Then I slept. A lot.

I already have a 1mm gap between my teeth, and I'm supposed to start turning the expander myself tonight! I was pretty surprised to hear that, since I think most people wait like 5 days or a week before they start turning. But apparently my surgeon is the guy that the Doctors go to, and send their kids to. My phase1 recovery nurse told me he's one of the best in the country. So, if he says start expanding tonight, expand I shall.

Sorry if this is a little rambly... I'm on demerol and it's making me a little loopy.

[slb1982]

Hi everyone,

I'm a newbie here and I'm having my SARPE surgery in exactly one week (Feb. 26). I'm 31 years old and really nervous about it. I have extremely crooked teeth and a SUPER crowded mouth because my upper palate is so much narrower than my lower. I'm not sure how to attach photos, but I'd like to do that if my experiences with this will help anyone else. Here is my quick dental timeline: I had my 4 wisdom teeth removed last year in August. Then I waited to get started on everything else because my insurance didn't kick in until January 1st, 2013. So.... January has begun my whole braces/SARPE journey.

I got spacers in between my back teeth (8 on top, 4 on bottom) on January 15th. A week later, on January 21st I got them taken out and had braces put on. This is my first experiences with braces ever... I'm not sure why the spacers were between all my back teeth because when they got taken off, the braces were then put on my front teeth. The braces were put on 6 front teeth and then 12 of my bottom teeth. Then about 3 weeks passed, and I just went back to my orthodontist on Feb. 18th and he put the top spacers back in (8 spacers on my upper back teeth) to get them ready for my expander (RPE).

Now it's February 19th and I've been on a soft food diet ever since my spacers were put on January 15th I'm getting so tired of eating the same things already.... Yogurt, applesauce, soup, mac & cheese, juice, mashed potatoes and scrambled eggs (mixed with Ragu pasta sauce) have been my main meals. Also, I'm finding the spacers to be extremely painful on my back teeth... and all of my front teeth have been EXTREMELY sentitive to ANY sort of pressure, ever since I got my braces on. I am only able to SORT OF mash with my back teeth right now.

I go back to the orthodontist next week (Feb. 25) to get the spacers out and my expander put in.... And the my SARPE is Feb. 26. I'm so nervous about the swelling and bruising and nose bleeds and throwing up blood that I've read about :/ But I suppose I should be trying REALLY HARD to focus on the positives, right? In over one week, my SARPE will be done, and then it'll be onto recovery. I am lucky to have a great husband to help me out. But I still need to buy a recliner to sleep in! (We just moved into a new place but have no furniture yet ~ not the best for recovery).

I've read that some people don't get their braces on until months after surgery, but my surgery is going to be done while I have already had my braces on for about 5 weeks (they haven't been moving my teeth - I think they've just been on so that my mouth could get used to them before the surgery & also so that my mouth could get molded for the expander with them on). After the surgery, I think I'm supposed to start cranking right away. My total expansion will be approx. 7 or 8mm. My orthodontist wants me to check in and see him back at his office 2 days after surgery and I'm REALLY not looking forward to that... Will I really feel upto going into the orthodontist 2 days after my SARPE? I'm sure I'll be super swollen and won't want anyone in his office to see me, let alone feel upto travelling in a vehicle. Oh well. I will keep you all posted if it will help.

[katsface]

It's been a little over a week since surgery. Most of the swelling has gone down, and the bruising on the sides of my face is fading, but still visible.

My surgeon said my face wouldn't change much at all, but I feel like I look like a different person. I swear, it looks like he brought my maxilla forward, something we did not discuss. And, my nostrils are wider and my nose turns up at the end. It's not quite as bad as it was immediately after surgery, but it's still not the same nose that I went in with. I'll ask the OS tomorrow at our first post op appointment if it will go back to normal or not. I might just have some residual swelling that's making my face look funny.

I went to the Ortho on Monday, and I'm not too happy about the experience I had. I emailed to let them know when I scheduled my surgery (I got a reply that they would get back to me if I needed to move appointments around... and they never emailed back) and I emailed again a couple days after surgery to let them know that it went OK, but that I wasn't sure exactly what was supposed to happen at my upcoming appointment since I will still be swollen and I'll have a lot of expanding to do still. No reply.

So, when I arrived at the appointment, I asked what they were doing, and the assistant said "putting in your upper arch wire". So of course, I was confused, and said, "Umm... I Just had surgery last week ??" And, the assistant said, "well, I guess we're not doing that then" as if I hadn't told them, TWICE, that I was having/had surgery on the 18th.

She then measured my expander, decided that I was at 2.5 mm (which I could have told her over the phone) and told me to cancel my next appointment and reschedule two more to have an impression done for a fake tooth, and to have my lower arch expander installed.

So, she calculates in her head that I have 16 days of expanding left (that doesn't sound right to me, but she's the expert, right?) and tells me to go make the appointments. I had to pry it out of her exactly WHEN I was to make appointments, as she just said I need the two appointments for impressions, and instillation, not when they should happen. So I go to the front, make the appointments, and leave. I could have done ALL of that over the phone and not had my friend drive 20 min. to pick me up, 20 min to get to the appointment, and then 20 min to take me home. (My husband and I don't own a car...)

So I get home, and I realize her estimate for when I should be done expanding is WAY off. I didn't have 16 more days, I had 21 more days! So now i have to call back and cancel the appointments I JUST MADE and reschedule them for the appropriate times.

I'm not really sure what to do about this, as I've been through a hell of a lot int he past week, and I'm paying them a TON of money, and I am expecting a little better experience than that.

What would you do? Would you email/call and complain?

[Vantwins]

Hi Kat - congrats on your surgery! My nose was funny for awhile, upturned at the tip, I think it went back to normal after 6 weeks maybe when the swelling was totally gone. No, not impressed with your service at the orthodontist!!! Is this an issue with the staff or the orthodontist? Sounds like the staff doesn't have their act together, and yes, I would complain to the ortho! But otherwise, sounds like you are in good spirits, so that's good!

slb - welcome! I guess you just had your surgery? Hope you are recovering well! No, you will not feel like going to the ortho right after surgery and there's nothing they can do then anyway. I know my ortho wanted to see me about 4 days after surgery and I called and rescheduled for a week later. Even then, I was still swollen and super dizzy when they reclined the seat.

My saga continues! I went to a periodontist who said the first ortho never should've put the braces on because I have such severe recession that it's not healthy to move the teeth. I had gum grafting on 6 top teeth a couple weeks ago. After getting back to a mostly normal diet, I had to eat mush again for a week. Now my gums are healing and in a few weeks I'll get my top braces back on with my new ortho. My gap is moving together on it's own, but basically I have a triangle now - the bottom tips of the teeth are touching but there's still a gap at the top. I definitely still look very strange! I'm surprisingly used to it now though. So, after I get the braces, I need a bunch more gum grafting on the bottom gums and then need to wait another 6 weeks for the bottom braces. And then 9 - 12 months till my double jaw surgery. I did end up negotiating with the old ortho and getting a decent refund. The new ortho is twice as expensive, so I'll need it, but I'm starting to think you get what you pay for!

My happy news is that it took 3 months, but finally this week I can eat baby carrots, and nuts, and crunchy granola bars again! I just didn't have the force to chew such crunchy things till now. Those are all my grab and go kind of snacks, so I'm very happy!

Looking forward to hearing more of your recoveries!
Vanessa

[katsface]

Latest update: follow-up w/surgeon, bones healed too quickly and the ones in the front had to be re-broken. So, that happened on Tuesday, I worked on Wednesday and iced a LOT both at home and at work. Bruising was kept to a minimum, but I woke up on Thursday with my face unbelievably swollen, and my eyes nearly swollen shut! So, called the doc and got Prednisone. A day later (today / Friday) and I can open my eyes most of the way. Whew - never saw that coming (no pun intended). I saw the ortho on Wed AM and he was pretty surprised. But he gave me the good news that I could stop turning (as of yesterday) and I'm at a total expansion of 10mm. When I say the surgeon on Tue, the gap was at about 6; when I saw the ortho the next day, the gap was almost 9mm. So I'm glad I got the bones re-broken, even though it wasn't exactly fun. My next appt with ortho is 2/12 to get lower wires changed, and I get uppers braced on 3/14!

When you had to have your bone re-broken, was it becoming increasingly difficult to turn the expander key? Mine is becoming really tight, to the point that the expander key is bending when I try to turn the expander. It's still expanding, it just takes a few tries each time b/c the key will bend, and I have to bend it back, and try some more. I'm really hoping this is somewhat normal. I just saw my OS yesterday and he said everything looked fine, and that the key might bend sometimes. Sheesh! I just don't want to go through this again!

[katsface]

Update:

The expander key broke. I can't turn the expander at all anymore.

I called the emergency line yesterday at the orthodontist. I explained that I can't turn the key anymore, and that I'm worried that my bone will fuse / has fused together. The emergency technician got off the phone with me and tried to call the ortho. She called back and said she wasn't able to get hold of him, but told me she would call me back as soon as she heard from him, and I guess he never called back b/c I still haven't heard back.

She wants me to come in on Monday to see the Ortho but I don't have an appointment, and can't make one until tomorrow b/c the office is closed on weekends.

I'm really hoping that it's just a faulty expander, and maybe the screw is just stripped or stuck, but I won't know anything until I can get into their office.

I'm going to call first thing tomorrow and see if I can get an emergency appointment tomorrow afternoon.

I'll keep this process updated, just in case anyone ever runs into similar problems. I haven't been able to find many other accounts of this kind of situation online (though I have found a couple and the problem seems to be a faulty or broken expander). Hopefully in the future this account might help someone else.

[Vantwins]

Sorry you're having this issue, I hope you can get it resolved tomorrow. Have the ortho turn it a couple times for you at your appointment tomorrow.
Vanessa

[slb1982]

This is the 5th day after my SARPE surgery. (Day 6 I guess if you count the surgery day too, since the surgery was Tuesday morning and now it's Sunday night). The surgery went really well, and my husband drove me home right afterwards even though it was a 6-hour drive (and the drive was fine since I'm assuming I had alot of painkillers in my system from the IV). My nose only bled for a few minutes shortly after the surgery, but I just stuck kleenex in my nose until it stopped. I never threw up blood, so I was really happy about that. I pretty much slept all of day 1 and felt pretty good every time I woke up. Days 2-4 were the worst for me. I laid around alot and ate babyfood squeeze packets and drooled into a lot of paper towel. I also used a baby spoon to eat yogurt and pudding (the baby spoon was SO helpful because my mouth couldn't open very well). ALSO I took Sudafed nasal decongestant for the first 5 days because if I didn't, my nose would drip or get congested, so the Sudafed helped ALOT.

My facial swelling (cheeks & nose) didn't start until day 2 and it got worse until the morning of day 5. Day 5 is the day I started feeling a bit better finally. I bruised a tiny bit underneath my eyes on days 2-3, but it's only slighly yellow now on day 6 (pretty much gone). I do have really bad bruising on the right side of my chin though. It's really black and blue and looks like I got beat up. My overall swelling finally went down a LITTLE bit on days 5 & 6, but I still look like a completely different person.

Kat - my nose looks different too - It's what I'm most concerned about right now. It looks way wider than it normally does, and I'm hoping it's just due to the swelling. I'll be so happy when it looks normal again. I do not like my nose right now. I look so weird. And my face still looks really puffy. I'm also sorry to hear about your problems with cranking Are you cranking once a day? How many millimeters total? I'm sorry if that info was already printed & I missed reading it. Please keep us updated on what happens.

I had a small gap immediately after surgery (about one turn, or 1/4 mm), and I was told to start cranking that night. Since then my husband has cranked it twice a day (morning & night), so now that's it's Sunday night we have cranked the expander 11 times (12 times, counting the surgeon's crank) so my gap is at 3 mm on the night of day 6. I'm supposed to crank for one more week, for a total of 7 mm.

As of right now, I'm still not exactly sure what I think of this. The surgery itself was no way near as bad as I thought it would be, and although recovery was pretty bad for the first 5 days, I've actually had the flu worse than this. As long as the results turn out well, then I think the surgery & recovery period aren't too bad. Right now I'm most concerned about the cranking part ending up ok and also my face returning bad to normal. I really hate this wide nose & puffy face. I did eat (swallow) spiral macaroni and cheese tonight finally, and although I couldn't actually chew it & it got stuck really bad up in my expander, it was totally worth it.

[katsface]

This is the 5th day after my SARPE surgery. (Day 6 I guess if you count the surgery day too, since the surgery was Tuesday morning and now it's Sunday night). The surgery went really well, and my husband drove me home right afterwards even though it was a 6-hour drive (and the drive was fine since I'm assuming I had alot of painkillers in my system from the IV). My nose only bled for a few minutes shortly after the surgery, but I just stuck kleenex in my nose until it stopped. I never threw up blood, so I was really happy about that. I pretty much slept all of day 1 and felt pretty good every time I woke up. Days 2-4 were the worst for me. I laid around alot and ate babyfood squeeze packets and drooled into a lot of paper towel. I also used a baby spoon to eat yogurt and pudding (the baby spoon was SO helpful because my mouth couldn't open very well). ALSO I took Sudafed nasal decongestant for the first 5 days because if I didn't, my nose would drip or get congested, so the Sudafed helped ALOT.

My facial swelling (cheeks & nose) didn't start until day 2 and it got worse until the morning of day 5. Day 5 is the day I started feeling a bit better finally. I bruised a tiny bit underneath my eyes on days 2-3, but it's only slighly yellow now on day 6 (pretty much gone). I do have really bad bruising on the right side of my chin though. It's really black and blue and looks like I got beat up. My overall swelling finally went down a LITTLE bit on days 5 & 6, but I still look like a completely different person.

Kat - my nose looks different too - It's what I'm most concerned about right now. It looks way wider than it normally does, and I'm hoping it's just due to the swelling. I'll be so happy when it looks normal again. I do not like my nose right now. I look so weird. And my face still looks really puffy. I'm also sorry to hear about your problems with cranking Are you cranking once a day? How many millimeters total? I'm sorry if that info was already printed & I missed reading it. Please keep us updated on what happens.

I had a small gap immediately after surgery (about one turn, or 1/4 mm), and I was told to start cranking that night. Since then my husband has cranked it twice a day (morning & night), so now that's it's Sunday night we have cranked the expander 11 times (12 times, counting the surgeon's crank) so my gap is at 3 mm on the night of day 6. I'm supposed to crank for one more week, for a total of 7 mm.

As of right now, I'm still not exactly sure what I think of this. The surgery itself was no way near as bad as I thought it would be, and although recovery was pretty bad for the first 5 days, I've actually had the flu worse than this. As long as the results turn out well, then I think the surgery & recovery period aren't too bad. Right now I'm most concerned about the cranking part ending up ok and also my face returning bad to normal. I really hate this wide nose & puffy face. I did eat (swallow) spiral macaroni and cheese tonight finally, and although I couldn't actually chew it & it got stuck really bad up in my expander, it was totally worth it.

I'm glad to hear you're recovering! Luckily my swelling went down really quickly (the doctors have been impressed) and I think that taking Bromelain had helped A LOT. So, you might look into that to help the swelling come down some. Other things I think helped were getting up and taking a long walk on day 5 or 6 (at my husband's request we took a 1 or 2 mile walk around our neighborhood).

And I started eating real food right away, which I think has helped me recover quickly. I've been eating really healthy (according to my conception of healthy, which I realize is different for lots of people). I don't eat grains because I'm gluten intolerant and most grains (especially wheat and corn) give me very bad effects like IBS symptoms, aching joints, and heartburn. Grains also have a chemical called phytic acid that prevents you from absorbing minerals and nutrients... so in an effort to absorb all of the nutrition I can I've been avoiding all grains and sticking to meat, fish, eggs, berries, and soft vegetables like sweet potatoes. I can 'chew' just about anything at this point, but at first eggs, lactose free full fat yogurt, and well braised meat (which I cooked with extra bone broth for extra nutrition) were life savers. Anyway, long story short, give your body a fighting chance with good quality building blocks, and it will thank you .

I started turning the expander the day after the surgery. I'm supposed do it twice a day, and it expands 1/4 of a millimeter each turn, (1/2 a millimeter each day). I'm supposed to go to 13mm. The surgeon turned it about four times during surgery, so I started off with a 1mm gap. I have an emergency appointment to find out what's wrong with the expander today at 4:10, so hopefully I'll find out what's up and how far I have to go still. If the expander had worked correctly I would be at 7.5mm - 7.75mm today, including the 1mm the surgeon did. But, I'm guessing I'm at more like 4.5 based on the space at the middle of the expander.

I felt the same way, so tired of the puffy face and piggy nose! It's still not quite the same nose I started with, but each day as the swelling goes down I become more and more recognizable. No one but my surgeon and myself could tell I have any swelling 10 days after surgery, but it's still enough to distort my nose, apparently. At this point, it's close enough to normal that I don't mind if it stays like it is. And my husband keeps reminding me that I'm only 2 weeks post op (as of today!) and I really shouldn't expect to be 100% yet. He's a pretty smart guy I read something that said you really won't know what your face looks like for 6 months as all of the swelling resolves, and the teeth move etc. So, I guess we'll see, but I think your nose will get better soon

[katsface]

UPDATE: Good News!

The screw was just really stuck! I just got back from the ortho's office. The assistant got a special key that's stronger than the blue one, and got the expander to move. She gave is a couple of good turns, and then wiggled it back and forth to loosen it up.

She said that the screw is coated with something at the factory that can make it really tight sometimes. She gave me two new keys (a blue one, and the special stronger key). She measured the expander gap and I'm a couple of millimeters behind, but the expander is working. She checked my palate and said everything looks like it should.

The expander gap was at about 4.75mm when I went in, and she brought it up to 5.25 while I was there.

Yay! I'm so happy! Thank you guys for bearing with me as I went trough this. I was just really freaked out that the surgery failed, but now I feel SO much better.