The Dreaded RPE Appliance! :(

Me in my new mouth jewerly! NOT....This is my new RPE (torture device)appliance:




Had my ortho appt this morning and the RPE torture device was placed. At first I thought it wasn't going to be so bad, but as my day wears on I'm really starting to dislike this device. The appliance itself sits about 1/2 an inch from the roof of my mouth. If you have a serious gag reflex I could see how it might really be annoying, but since I don't really have too much of one, that part is not too bad. My mouth is watering like crazy, so it is next to impossible to talk for more than a couple of seconds without having to suck all my spit up. I have noticed that it seems to interfer with the normal tongue thrust that goes along with drinking and swallowing also. It is not something I totally can't bear, and at this point it is not painful at all, just more annoying than anything else. It is definitely going to take some getting use to. Drinking my morning coffee was quite a challenge today. Liquids now go up over the top of the appliance between the roof of my mouth, and since my tongue is not thrusting normally, the fluid is hard to control. I ended up choking on it twice while only drinking a small amount. I tried a straw but that didn't seem to make much difference either. Talking is quite a challenge too, I have noticed that if I don't try and fight against the appliance as much, that the words come out a bit easier to understand. Talking, without drooling is going to take a bit of practice.

Eating is a totally different ball of wax, very very unpleasant and hard! My tongue is getting very sore from rubbing against the appliance, and from having to constantly keep myself from drooling everywhere. I"m hoping that eventually I will develop some type of technique that works but so far I have not found anything remarkable yet. At this moment I'm wondering how I will ever survive at work with this appliance. Eating was not pretty tonight and requires a lot of sucking noises that would not be appropriate in mixed company. Hopefully my mouth will figure out soon that this piece of metal is not food, and the water works will decrease.

OMG! I almost forgot! I asked my ortho how much expansion we were going for this morning. He says they are going for an 8mm expansion! I was like 8MM???? I originally thought maybe 6, but certainly not 8mm! I'm going to have a freakin garage between my teeth!

I talked with my ortho this morning regarding my sleep appliance, as it is really not working for me. Since he made the modifications on it the other day it keeps popping off my teeth, and it is really uncomfortable with the pressure it is applying to my upper teeth and arch to hold it in place. He replaced 2 of my lower molar brackets with hooks, and put two hooks on my eye teeth. He then used class 3 (really strong) rubber bands to pull my jaw forward. It feels like it is going to work so I will post tomorrow after I try sleeping with them tonight.



Brandy

4 Days and counting.....

Ok, I faxed a picture of my sleep appliance to my O.S today (he has seen it before but I wanted to refresh his memory) I told him my concerns about discomfort, and possible issues arising from the pressure on my palate right after the SARPE. He looked at it, and also showed it to the other surgeon in the office, and as much as I don't like it.....they were in concurrence with my orthodontist. They all seem to think it is going to be fine after the SARPE, no problems. So, I guess I will just wait and see how it goes. If they are wrong then I will be talking with my Ortho about alternatives, but for now I guess I will just wait it out and see what transpires.

I have a lot of lower teeth pain today! It is weird but whenever I get spacers on my top teeth, it makes my lower teeth hurt! Kind of bizarre huh?

RPE goes in tomorrow morning at 7:20 am. I will post after it is in.

Brandy

5 Days til SARPE

Posted: Sun Feb 26, 2006 11:42 am Post subject:

Ok...I'm starting to get a little nervous about this. I"m trying hard to keep the overall pre-surgery "FREAK OUT" at bay, but I can feel the anxiety starting to creep in a bit.

Spacers are doing fine, I can hardly feel them at all now. They did aggravate my lower teeth a bit yesterday but today they are much better. Tuesday morning they will come out and I will have the RPE (Rapid Palate Expansion) appliance put in temporary until Friday. It will not be permanently cemented. My oral surgeon says he needs to have it out during the surgery, and that when he is done he will put it back in, turn it a couple of times to make sure everything is working, then cement it in permanently himself.

I have to go talk with my Oral Surgeon tomorrow anyway. I use a dental sleep appliance for my sleep apnea. Basically it pulls my jaw into a forward position and holds it there by anchoring it against my front teeth and upper arch. My ortho ground it down a bit so it would fit better over my lower braces, and seems convinced that I should be able to wear it after the SARPE. I'm not comfortable with this at all! I'm going to have stitches everywhere, plus a molar extraction on the bottom. Plus I'm not at all comfortable with an appliance that relies on my upper arch/palate for support, when my palate is going to be fractured! That is just messed up I think!

I talked with my ortho Thursday about us having to maybe get creative to deal with this, as I do not want to use a CPAP machine for 3 or 4 months just so I can breathe at night. I suggested that perhaps we try and develop something similar to headgear that only attaches to my lower teeth. That way it would pull my jaw forward at night, and it would be anchored in that position with the neck strap, completely independent of my upper palate. I get the impression he is looking for the easy way out and doesn't really want to bother with it. SO....I'm going to show my OS my appliance and see what he says. If he says "NO WAY, that is just not going to work" then I'm going to force the issue with my ortho and make him come up with something different before the surgery on Friday!

I have to be able to sleep in order to heal, and I sorta resent the fact that my ortho is not taking my sleep apnea seriously. He said something the other day like "oh I didn't realize it was so serious" Duh....I wake 25-30 times and hour without my appliance, and I'm going through all of this ortho, SARPE, and Jaw surgery because its no big deal! HELLO! GET A FREAKIN CLUE! Anyway...I will post what we come up with. I know this type of thing is relatively new and perhaps it will help someone to see what we did to handle it.

Day 18/ Dr. Explains SARPE

Posted: Fri Feb 24, 2006 7:38 pm Post subject:

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OK...today is day 18. Spacers went in Thursday morning, and well my teeth are a little irritated right now. I do have to say that the spacers are no where near as bad as they were the last time I had them in (just about 2 weeks ago.) My teeth are tender, mostly just on one side, but it is not that bad.

I talked with my OS and asked about my SARPE and how it will be done. He told me that they will not be going through my palate like I had thought (which was a big relief for me) but through the outside of my gums (between my cheeks) up in my molar area to release/fracture the connecting jaw bones. Then they will make a small verticle incision above my front teeth, right below my nose where they will gently release the palate bone. He said while he is releasing the bone on my left side, he will also remove an impacted wisdom tooth I have. When he has completed the palate expansion, retrieved the wisdom tooth, installed the appliance, turned it a couple of times, and stiched me all up. He will then go after my lower left first molar for extraction. He says the whole thing will likely take about 2.5 hours. This is all being done in his office under I.V sedation.
He swears I will be in a happy place and not know at all what is going on. He says I will go to sleep, and it will seem like I'm immediately being woken up with everything completed. I hope he's right, as I surely don't want to feel any of this!

Sounds awful huh? Oh well, whats a girl to do? I guess it will be good that I will be having all of my pain at once!

I will post again when I get the appliance in on Tuesday.

Brandy

RPE appliance fitting

Posted: Mon Feb 13, 2006 11:21 pm Post subject:

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Ok...today is day 7. I was fitted for my RPE appliance today, and well it(the actual appliance) didn't seem too bad (for the short time I had it in my mouth that is.) I go back next Thursday for spacers, then the following Tuesday they will place the RPE temporarily. I will have it for 3 days before I go in for surgery on the 3rd and my Oral Surgeon cements it in for at least 4 months.

As for the braces, everything is fine now. Teeth are still a bit tender but nothing to really complain about. Mouth is doing well, and as long as I don't talk for a really long time, or eat to much my mouth feels fine.

My son was fitted with Braces today also, so now we are twinzies! It's nice having someone who can relate to what you are going through.

Day 5 in Braces

Posted: Sat Feb 11, 2006 10:57 pm Post subject:

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Ok..today is day five and all is well in my mouth thank goodness. By day 4 I had virtually no mouth soreness and was eating much more normally. Today I have had no rubbing, feels like the braces have been in my mouth forever. I can still feel pressure on different teeth, and it definitely seems to migrate around on a daily basis but it is not anything that is too annoying.
Depending on what I eat it can still be challenging and definitely requires a bit more concentration and time, but for the most part things are going great and I'm happy to be moving forward in my bite makeover.

Brandy

Day 3 In Braces

>Posted: Thu Feb 09, 2006 7:05 pm Post subject:

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Ok...today is day 3 with my braces on. Things are gradually getting better and better. Although wax is still my best friend, the sores are getting smaller and tougher, and not near as aggravating, and I'm no longer having to live on Advil and Tylenol. My teeth are less sore now and I'm actually able to chew and eat semi hard food.

I actually feel like I can stand these things today, and I'm confident that I will be ok with this. It is amazing what your mouth will adapt too! LOL...

I keep checking my teeth for movement but don't see anything noticible as of yet!


Brandy

Why I'm going through all this/ Day 1 in braces

Posted: Tue Feb 07, 2006 9:29 am Post subject: Brandy's Braces, SARPE, and eventual Jaw Surgery Journal

I had a hard time finding good info on my procedures so I figured I would start an online journal and then anyone interested can read it. I will be having a Surgically Assisted Rapid Palate Expansion on March 3rd. I will then be wearing an RPE (rapid palate expander device.) for approximately 4-5 months. I will be wearing braces for approximately a year during this process, and if everything goes as planned, we are preparing for my BSSO (bilateral saggital split osteotomy) or lower jaw surgery. to align my bite, and eliminate my overbite, in May 2007. I have always had an overbite, and when I was young the ortho wanted to break my jaw, pull it forward, and wire it together. My parents could only afford braces for one kid, and since my brothers teeth were far worse than mine we just left mine alone, and put braces on him. Why do I need all this????

I'm currently 41 years old. Recently, in the last year, I was tired all the time, and constantly getting sinus infections. My ENT doctor recommended a sleep study and found out that I had "Upper Airway Resistance Sleep Apnea" and was waking approximately 23-30 times per hour. The doctors (my ENT, OR, Ortho, and Dentist) all agreed it was due directly to my retronathic jaw. I'm not overweight, or your normal sleep apnea type patient, I'm healthy, fit, eat right, and don't drink or smoke. I have always been an incredibly light sleeper though, and it is now suspected that I may have had mild sleep apnea my whole life without even knowing it. Being quite young at heart, and very active, I refused to use one of those big CPAP air machines at night. I opted for a specially designed sleep apnea appliance that basically pulls my jaw forward at night and holds it there to keep my breathing passages open. After wearing the appliance for a year with great results, I decided that I did not want to use a sleep appliance forever and began pursuing the ortho/surgery option to correct my sleep apnea issues. The above diagnosis is a result of deciding to pursue this option, and the rest of this journal will be devoted to documenting my experiences during this whole process.

So here it goes........ Spacers when in on Friday February 3rd. I walked out of the ortho's office thinking....this isn't too bad I can handle it. Well the next two days proceeded to get progressively more painful and unpleasant. So let me be the first to say that I DO NOT LIKE spacers. Over the weekend one of them fell out so I went in yesterday morning (Feb 6th) to have it replaced. The weather had been very bad the night before and they had had a ton of cancellations at the ortho office. I arrived and the doctor asked if I had time and wanted to get fitted for my bands and do impressions for my appliance today. Since this would save me time in the long run I said "Sure, lets go for it" Bands were fitted, and even though my teeth were quite sensitive, it wasn't near as bad as I thought it would be. They slid on pretty easy, and the whole process was relatively painless (other than the biting down to push them completely in part.) Next came the impression.....another painless procedure that didn't take much time at all.

Just when I thought I was finished for the day, my ortho comes back and says. "you want to get your braces on today? We have some time open if you've got the time" Since the schools were closed today I had nothing but time on my hands so I said "Yeah....sure I guess" I was supposed to get my braces put on on the 13th of February with my son. Instead I got mine a week early. The whole process of braces being put on was a piece of cake. It took about an hour and a half from beginning to end ( for both top and bottom) and was virtually painless. I did have to taste some pretty nasty stuff that got rinsed out of my mouth when they were priming my teeth, but other than that it was a no brainer....just basically sat there with a cheek spreader in my mouth, while my ortho individually placed each bracket on my teeth. The tech put in my first archwire and short of feeling a bit of pressure on my teeth immediately I was good to go. I had TIME2 self ligating brackets placed on my teeth. It has been almost 24 hours with them and things seem to be going fine. They are a bit scratchy but I have been taking all the advice I have found on this board and using my "braze eze" before my mouth gets shredded, gargling with salt water regularly, and just not talking too much until my mouth adapts. My teeth feel much more tender this morning...mostly the ones in front but are not miserably sore or anything I can't handle. Here are a pre and post pic:








So....that is about it for now. I will post again in a couple days on my braces progress. My plan is to post all the way through all my surgeries with very explicit detail, as I had a hard time finding this sort of thing during my research. Hopefully this will be helpful to some of you