Author Topic: Fist post I think  (Read 8129 times)

kavan

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Re: Fist post I think
« Reply #15 on: January 08, 2018, 09:33:29 AM »
Another update, been snowed in for 5 days,  appointment was cancelled  twice more due to weather.  I will be going this Wed for jaw surgery consult and also to discuss tooth extraction,  tooth under one of my crowns decided to crack New Years morning.  According to two dentist the tooth can not be saved.  I will discuss haveing tooth extracted and discuss when it will be best to get implant put in and how that will work with braces.

I think that braces aimed at moving the teeth are not compatible with implants. However, implants can be placed at later time after the bimax surgery. Be sure to discuss that WITH the surgeon actually booked to DO the jaw surgery.
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uncleg

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Re: Fist post I think
« Reply #16 on: January 09, 2018, 08:44:01 AM »
Thanx, I will be seeing him tomorrow and that question is on top of my list.

uncleg

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Re: Fist post I think
« Reply #17 on: January 12, 2018, 11:21:13 AM »
OK, I have attached what I got from surgeon the other day.  Let me apologize the photo of the before me and the after me results scanned dark and you will not be able to see it.  The predicted changes to my profile are minimal in my opinion, just a bit more of a chin and a little less neck.  Currently surgeon is setting up treatment plan and also working to get some insurance coverage.

[attachment deleted by admin]

kavan

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Re: Fist post I think
« Reply #18 on: January 12, 2018, 05:27:22 PM »
Can't see the photo but that is a piss poor ceph displacement analysis as to the changes. Have the doc add some chin augmentation.
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GJ

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Re: Fist post I think
« Reply #19 on: January 12, 2018, 05:36:42 PM »
Agree, that is a stone age/bad ceph. From the ceph, it appears you need only a genioplasty for aesthetics. What is your weight? If this is a sleep apnea case losing weight and a genio might be satisfactory. Sleep issues compound themselves. Do you view your bed and get anxious? If so, it's partially mental, and that should be addressed. That's not to say you don't have a legit physical problem, but you need to parse where the mental ends and physical begins.
Millimeters are miles on the face.

kavan

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Re: Fist post I think
« Reply #20 on: January 12, 2018, 05:57:12 PM »
Agree, that is a stone age/bad ceph. From the ceph, it appears you need only a genioplasty for aesthetics. What is your weight? If this is a sleep apnea case losing weight and a genio might be satisfactory. Sleep issues compound themselves. Do you view your bed and get anxious? If so, it's partially mental, and that should be addressed. That's not to say you don't have a legit physical problem, but you need to parse where the mental ends and physical begins.

Looks like straight forward linear advancement too given the displacements are same for mandible and maxilla. This doc has not done much to maximize the op's aesthetics. Seems lazy with that ceph and 'even' displacements.
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CCW

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Re: Fist post I think
« Reply #21 on: January 13, 2018, 12:04:29 PM »
You should get a second or third opinion especially considering you're taking out a loan to pay for the surgery. I'd consider Dr. Gunson. He's probably the best and cares about aesthetics as much as he cares about the airway and bite.

uncleg

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Re: Fist post I think
« Reply #22 on: January 16, 2018, 06:11:47 AM »
Thanx for the feed back,  I should have stated that this is just a preliminary model, just concerned with moving jaws out the maximum they can safely and aesthetically do to open my narrow airway as much as possible.  When I go back for the next appointment to see the treatment plan I should have a better idea of the finished product after fine tuning.  We did discuss chin augmentation and it will be done.

The surgeon did suggest I get a second opinion so if anybody could recommend a surgeon on the East coast, I would appreciate it.  I am in SC.

uncleg

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Re: Fist post I think
« Reply #23 on: January 16, 2018, 06:22:02 AM »
Agree, that is a stone age/bad ceph. From the ceph, it appears you need only a genioplasty for aesthetics. What is your weight? If this is a sleep apnea case losing weight and a genio might be satisfactory. Sleep issues compound themselves. Do you view your bed and get anxious? If so, it's partially mental, and that should be addressed. That's not to say you don't have a legit physical problem, but you need to parse where the mental ends and physical begins.

I was diagnosed with severe sleep apnea, two years ago,  poor sleep has always been an issue with me.  I have a very narrow airway, I am actually smaller than the example of a narrow airway I was shown in Doctors office.

"Do you view your bed and get anxious? If so, it's partially mental, and that should be addressed"  Very true and I have addressed those issues with a sleep therapist and have overcome those mental issue.  He is the one who sent me to an oral surgeon.

Me, Male 52 years old, 5ft 6, currently 165lbs, not my lightest or my heaviest.   I much prefer to be at 150lbs, I gained a few pounds over the last year due to an injury and not going to gym like I should.

kavan

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Re: Fist post I think
« Reply #24 on: January 16, 2018, 07:46:45 AM »
Preliminary model indeed. It looks like a primitive cave painting.

Basically, what the proposal reflects is EQUAL linear advancement of both jaws. Not saying this would not work to increase your airway because it would most likely do that. But as far as the proposal is concerned, it's the most straight forward thing a maxfax can do. That is to say, advancing both jaws equally is the EASIEST plan for a maxfax to do and does not reflect any sophistication in terms of maximizing the aesthetics.

You say you have 'The Best' (in South Carolina?) for this. Yet the plan reflects what any 'garden variety' maxfax can do. IMO, it also reflects a doc who is used to getting INSURANCE PAYMENTS for sleep apnea and just doing the minimum of what needs to be done to open the airway. OK. Fine. But insurance is not paying for this. It's self pay.

That said, if this is SELF PAY for a plan of equal linear advancement, your options are OPEN to a variety of maxfax docs because it's a straight forward plan for which the 'best' is not needed. The 'best' would have a better plan than what he showed. They guy didn't even add chin augmentation to it.
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GJ

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Re: Fist post I think
« Reply #25 on: January 16, 2018, 08:02:28 PM »
"Do you view your bed and get anxious? If so, it's partially mental, and that should be addressed"  Very true and I have addressed those issues with a sleep therapist and have overcome those mental issue.  He is the one who sent me to an oral surgeon.

Can you share what and how you addressed it? It might help others.
Millimeters are miles on the face.

uncleg

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Re: Fist post I think
« Reply #26 on: January 17, 2018, 08:53:05 AM »
Can you share what and how you addressed it? It might help others.

OK
A little background first I have sleep problems all my life, my Mother often said she had a 3 week old that slept through the night and a 3 year old (me) that had never slept through the night.  For me going to bed became a hassle, being reprimanded for not going to sleep, threatened that Santa, Easter Bunny would not come if I did not sleep, I know kid stuff but that was serious stuff for a kid.  When I got older, it was I was to nosy and would not sleep for fear of missing something.   I know I drove my sleep deprived parents nuts. So early on the bedroom/bed became a negative place.  I became a night owl after I left home for college, hotels were just places I stayed until sun came up.

Anyway how I got help, first I was sent to a sleep specialist and he had me read and go through all the steps the book No More Sleepless Nights.  I cleaned up my sleep hygiene, only used the bed for sleeping. I try to take a few hours of down time before bed, no stimulation, often just sitting in a low light environment unwinding until time for bed, have a set bed time and wake up time. I also made changes to my room, since I had negative feelings about the room.  I repainted, new bedroom furniture and mattress, blackout curtains and I also use background sound, I use winter blizzard sounds on Youtube.  I just made the room a more positive space and comfortable, somewhere I want to be.

All this helped, but it is hard to maintain, if practiced 7 days a week, I would have no social life and nothing would done after I got home from work other than eating supper.  I will also admit the slightest thing will throw me off, I am better at getting to sleep than I was, but staying asleep is another story.

I hope this helped, ask a question I will be happy to answer.